What Is A Pacemaker?

Posted on August 24, 2021

When John Hopps, the "Father of biomedical engineering in Canada," was busy tinkering with methods to pasteurize beer, he wasn't yet aware of how his other scientific studies would transform the world of cardiac medicine. 

With the help of surgeon Wilfred Bigelow and research student John Callaghan, the team realized that a cooled, immobilized heart could be stimulated by tiny electrical currents. The pacing of these electrical currents would ensure the contractions could continue over an extended period of time.  

With that discovery, Canada gets credit for inventing the first pacemaker prototype. 

A decade later, an advanced version of the first implantable pacemaker would be surgically inserted into the chest of a complete heart blockage patient. Though this early technology was imperfect, the outcome of these procedures would ultimately result in this becoming one of the greatest medical inventions in Canadian history. 

And the impact? An incredible 600,000 pacemakers take place for heart patients every year.  

How Does a Pacemaker Work?

The heart has a natural electrical system that controls the heartbeat. This conduction system causes the components of the heart to contract and pump blood. 

A doctor may prescribe a pacemaker if a patient has a slow or irregular heartbeat due to:

  • Medication
  • Surgical complications
  • Heart attack
  • Pre-existing cardiovascular condition

A pacemaker is a tiny device placed under the person's chest to assists the heart's electrical system to pump at a healthy adult rate (60 to 100 beats a minute at rest). The pacemaker will not need to function if the heart is working properly, but will signal to the heart to make corrections when needed. 

The combination of a pulse generator (the familiar metal container that contains the battery) and 1-3 electrodes (leads) connect to the heart chambers and deliver appropriate heart pulses. 

Modern pacemakers can even detect when a person is exercising. In this scenario, the increased demand for oxygen in the body will require the heart to beat faster. 

The Pacemaker Procedure 

Because it is not open-heart surgery, the device is usually implanted directly under the skin. While a doctor might insert a smaller pacemaker through a catheter and string up into the right ventricle of the heart, traditional pacemakers are inserted through an incision in the upper chest. In both procedures, the doctor will program the device and ensure that it is working properly. 

After a patient experiences their first pacemaker procedure, their life expectancy is usually expectant by their age. During a 2004 study, the median life expectancy for pacemakers was 8.5 years-- however, 44.8% of patients were alive after 10 years and 21.4% were alive after 20 years. The commonality between all of these cases is that most of the patients were able to enjoy additional years free of cardiac incidents. 

Who Qualifies for A Pacemaker?

While a doctor will ultimately make the final recommendation, there are a few common signs that you may need a pacemaker. If you are experiencing any of the following symptoms or qualifiers, it may be time to get a medical opinion about the health of your heartbeat: 

  • Low blood pressure
  • Fatigue
  • Arrhythmias or intense pounding in your chest
  • Difficulty breathing
  • You take medication that slows your heartbeat
  • Chest pain or heart disease

The following heart conditions may inevitably result in a pacemaker recommendation: 

  • Bradyarrhythmias (slow heart rate-- below 60 beats per minute)
  • Heart failure
  • Hypertrophic cardiomyopathy.
  • Fainting spells (syncope) 

Because there are no national benchmarks for access to quick cardiovascular procedures, there may be a wait time in order to receive your new pacemaker. Unless a doctor evaluates a high risk of morbidity, it can take 3-8 weeks to have a pacemaker procedure scheduled in Canada. Consult with your doctor to see if it's the right decision for your quality of life. 

Are There Different Types of Pacemakers?

Medical implant development has provided patients with more options to suit their individual needs. Three different types of pacemakers include the single chamber pacemaker, the dual-chamber pacemaker, and the biventricular pacemaker. The type of pacemaker selected by a patient's doctor will be determined by their condition, and how many chambers need to be paced. 

Single Chamber Pacemakers

A single chamber pacemaker carries electrical impulses to the right ventricle of the heart. Only one pacing lead attaches to the heart in a single-chamber pacemaker.

This pacemaker type is often used for an isolated sinus node dysfunction diagnosis.  

Dual Chamber Pacemakers 

A dual chamber pacemaker carries electrical impulses to the right ventricle and the right atrium of your heart to help control the timing of contractions between the two chambers. This requires two pacing leads, and is the most common type of pacemaker. 

Biventricular Pacemaker

A biventricular pacemaker stimulates the right and left lower chambers of the heart. It is commonly recommended for those who have experienced heart failure. 

How Long Does A Pacemaker Last?

The average lifespan of a pacemaker is 5-15 years. The failure or degradation of a pacemaker will require a replacement. 

Taking precautions against the following may increase the life expectancy of the device: 

  • Cell phones - keep 6 inches away or more
  • Magnets - keep 6 inches aware or more (preferably away) 
  • Anti-theft detectors - may momentarily interfere, so it's best to keep moving
  • Airport security metal detectors  - do not allow a hand-held scanner near your pacemaker
  • Arc welders and chainsaws - may interfere with the pacemaker 
  • Radiation therapy - can damage the circuits and will require special protection

If a patient comes into direct contact with any of these devices, they should seek medical attention to have their device examined. 

What Kind of Maintenance Does A Pacemaker Require?

A pacemaker contains a battery, which means that it will need to be replaced once it wears out. This usually happens every 5-15 years and will require minor surgery to change out the battery. 

During this minor procedure under anesthesia, the entire pacemaker battery is removed from its leads and replaced by a new generator. The small incision is sewn up, and the new pacemaker generator is monitored prior to a patient's discharge. 

Even if a cardiac pacemaker isn't due for a battery change, a doctor should examine the device every 3-6 months. During this appointment, the doctor will examine the device for: 

  • Productivity
  • Function
  • Programs
  • Accuracy
  • Ability to respond to exercise and exertion 

Failure to maintain your device could put a patient at serious risk. 

browsing the Canada health care plan

Do The Canadian Health Care Programs Cover Pacemakers?

Canada is famous for its publicly funded health care options. This Canadian Medicare coverage is responsible for protecting about 70% of Canadian health needs. Due to the way the program has been set up, these public plans are legally required to insure all medical services associated with: 

  • Hospitals
  • Physicians
  • Hospital-based dentistry  

If a service is medically necessary, the full cost must be covered by Canadian Medicare.  This is where it gets tricky. Though hospital-based medical services must be at least partially insured, the Canadian Health Act does not define what is "medically necessary." 

Because 80% of Canadians report that they have at least one risk factor for chronic disease (including smoking, physical inactivity, unhealthy eating, or alcohol use), chronic diseases (including cardiovascular disease) are responsible for approximately 65% of Canadian deaths. This means that concerns such as heart health and cardiovascular procedures should be considered "necessary" and covered under Canada's publicly funded health care system

Do Private Canadian Health Care Plans Cover Pacemakers?

If you are a citizen or permanent resident of Canada, public health care covers your prescribed implantation of a pacemaker. This is a financial relief, as patients who are not eligible to take advantage of the publicly funded health system can expect an uninsured pacemaker and heart-assist implant to cost $19,000-$96,000 or more. 

Though Canadians consider publicly funded health care to be a fundamental right, up to 70% may have some sort of supplemental healthcare to help cover prescription drugs, dentistry, and eye care.

If you require additional prescription drugs or therapies after your pacemaker procedure, you may want to look into a private healthcare plan

Advocate for Your Health 

Even John Hopps understood the value of the invention he had contributed to. At the age of 65, the engineer had his first pacemaker implanted in Ottawa. This procedure would contribute to an additional fifteen years of life-- a feat that may have otherwise been improbable without the right tools. 

Insurdinary wants you to have the same opportunities as you advocate for your quality of life. You don't need to be an accomplished scientist to receive an accurate quote for your best health insurance options-- so why wait? Submit your information today and receive a customized quote in just a few minutes. 

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