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Pacemaker

The heart has a collection of nerve cells near its top end that act as a natural pacemaker. This fires off signals about once a second to make the muscles of the heart contract and pump blood around the body. If this natural pacemaker is damaged, or the nerve fibers leading away from it are damaged, it will not function properly, and the heart will beat irregularly, at the wrong rate or not at all.

There are many reasons for the heart's pacemaker malfunctioning, the most common being a heart attack and a subsequent blockage of the nerve pathways within the heart, but many elderly people's pacemaker fail for no apparent reason.

To correct the failure of the natural pacemaker, a small but expensive electrical device is surgically implanted in the chest, usually under a local anesthetic, with tiny wires leading to the appropriate parts of the heart. This device is an artificial pacemaker, and it sends electrical signals to the heart on a regular basis to make the heart contract correctly. The pacemaker contains a battery, a timing device and the electrical stimulation mechanism.

The latest, more sophisticated pacemakers contain a computer that actually monitors the heart and only sends off an artificial signal when the heart's natural rhythm is disrupted variable rate pacemakers, which increase the heart's rate with exercise, are also available.

The pacemaker's electronics have to be checked every six to twelve months, but they will last from ten to fifteen years or more. These marvels of electronic miniaturization are keeping many people alive and giving many more a much better quality of life.