The Male Health Center

The Ticker Assistant

A pacemaker can keep an erratic heart running true
The wristwatch in the TV commercial may take a licking and keep on ticking, but each of us has a time piece that puts it to shame. For the average guy, the human heart keeps a reliable pace without even a change of batteries for over 72 years—the better part of 3 billion beats.

Eventually, though, it's not at all unusual for the heart to begin to have some timing troubles. The heart rate may become too slow to pump enough blood for vigorous activity, or it may occasionally accelerate to a flutter of as many 150 beats per minute, called fibrillation. Heart rate problems can turn an otherwise healthy person into an invalid—unless he or she gets a pacemaker.

A pacemaker provides electrical stimulation to the heart to maintain an appropriate beat and ensure full pumping capacity. About a half-inch thick and two-and-a-half-inches in diameter, the device is placed in the upper left portion of the chest under a flap of skin. One or more electrodes run from there through a vein to the right side of the heart.

Installation involves relatively minor surgery, making it a viable option even for people into their nineties. It can be done under local anesthetic, generally requiring only an overnight hospital stay. And once the skin has healed, the device is practically unnoticeable.

The first pacemakers, invented 35 years ago, were simple devices that constantly maintained one heart rate. Today, through developments in microelectronics, pacemakers can do much more.

Most modern pacemakers monitor the heart for irregularities and kick in only when the heart rate drops too low. This allows the heart to beat faster during exercise and prolongs the life of the device. The setting for activation can be reprogrammed from the outside without opening up the skin flap. And the unit's operation can be monitored over a telephone line, preventing frequent trips to the doctor's office.

Another major improvement is in resistance to interference. Most pacemakers now are unaffected by microwave ovens, airport security systems, and the like. Only major sources of electromagnetic radiation, such as arc welders and some medical devices, present problems.

Pacemakers use durable lithium batteries as a power source, but these eventually do run down. About every 10 years, the battery must be replaced, which requires opening the skin flap. Fortunately, the batteries don't fail suddenly. The pacemaker just becomes gradually less effective.

It's not likely that pacemakers will rival the heart itself for longevity, but they do offer many people several extra decades of active, enjoyable life.

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