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What is a Single chamber pacemaker ?

A Single chamber pacemaker is an electronic device used to treat patients who have symptoms caused by abnormally slow heartbeats. A pacemaker is capable of keeping track of the patient's heartbeats. If the patient's heart is beating too slowly, the pacemaker will generate electrical signals similar to the heart's natural signals, causing the heart to beat faster. The purpose of the Single chamber pacemaker is to maintain heartbeats so that adequate oxygen and nutrients are delivered through the blood to the organs of the body.

What are the causes of slow heart rates ?

Abnormally slow heart rates (bradycardias) can result from diseases affecting the SA node, the conduction tissues, and the AV node. Sick sinus syndrome is a disease wherein the SA node cannot generate signals frequently enough to maintain adequate heart rate. Heart blocks are conditions where diseases (such as heart attacks) or degeneration (due to processes such as aging) of the AV node and/or the conduction Single chamber the transmission of signals from the SA node to the heart muscles.

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Some medications can cause bradycardia. Examples of these medications include calcium channel blockers such as verapamil (Calan) and beta-blockers such as propanolol (Inderal) and digoxin (Lanoxin). These medications can also aggravate bradycardias in patients with existing diseases of the SA node, AV node, and other parts of the heart's conduction system.

The most common cause of Single chamber is degeneration of the conduction system that occurs as part of the aging process. Thus, people are more likely to need a pacemaker as they get older, both as part of the aging process and because older patients tend to have more medical problems that can cause slow heartbeats.

What happens when the heart beats too slowly ?

When the heart beats too slowly, an insufficient amount of blood reaches the organs. An insufficient supply of oxygen and nutrients can lead to malfunction and failure of the organs. The organ most affected by the lack of oxygen and glucose is the brain. Symptoms of insufficient blood supply to the brain include lightheadedness, forgetfulness, and loss of consciousness. Symptoms of inadequate blood supply to the muscles include tiredness, malaise, and fatigue. An insufficient blood supply to other organs can lead to heart, kidney, and liver failure. When an abnormally slow heart rate causes symptoms and/or organ failures, treatment for the slow heart rate becomes necessary.

Highly trained athletes with efficient cardiovascular systems can deliver all the oxygen and the nutrients the body needs with very slow heart rates. They typically have abnormally slow heart rates without any adverse symptoms or organ failures. Slow heart rates because of physical fitness do not need treatment.

What is the design of permanent pacemakers ?

A Single chamber pacemaker has two parts; the pacemaker chamber and the lead(s). The pacemaker chamber contains a timing device for setting the pacing rate, a circuitry that detects electrical signals from the heart, and a battery.

In some patients who need Single chamber pacemakers for abnormally slow heart rates, fluctuations of the heart rate can occur. The pacemaker is capable of "listening" to the natural electrical signals from the heart. When the heart is beating normally, the Single chamber pacemaker does nothing. When the heart stops beating or beats too slowly, the pacemaker takes over generating electrical signals for the heart at a frequency set by the doctor.

While temporary pacemakers are housed in Single chamber outside of the body and can use external electrical power sources, permanent pacemakers are implanted inside the body and therefore need their own batteries. Most of the modern permanent pacemaker chambers are small, weighing less than 30 grams. These small, lightweight devices are comfortable to wear inside the body and are barely visible. The small batteries inside the pacemaker chambers are also durable. Most implanted pacemakers have batteries that will last 7-10 years before needing to be replaced.

The conducting wire(s) that carry electrical signals between the heart and the pacemaker is usually made of platinum. These wires are insulated with silicone or polyurethane. The insulted wires are called leads. Some pacemakers have only one lead, and are called single-chamber pacemakers. Others have two leads and are called dual- chamber pacemakers.

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What outside electrical sources can interfere with the pacemaker ?

Magnetic resonance imaging (MRI scan) is a diagnostic test for studying the brain, the joints, the spine, the liver, and other organs. The strong magnetic field from the MRI scan can interfere with pacemakers. Patients with pacemakers should not undergo MRI scanning.

Digital cellular phones can interfere with pacemakers. Therefore, the cellular phone should be held on the ear opposite from the side of the pacemaker. Do not carry the phone in the pocket near the chest.

Theft detector gates in certain stores can generate signals that interfere with the pacemaker. While it is safe for patients with pacemakers to quickly walk through these gates, they should not stand at the gates or near them.

Similarly, the metal detector gates at airports can also interfere with the pacemaker. This problem can be avoided by presenting the pacemaker ID card to the security officers and walking around the gates. Hand held security wands (such as those used by security officers) have magnetic fields that can interfere with the device. Scanning by these wands should be avoided.

Heavy-duty electrical powered equipment such as arc welders, a running car engine, and certain electrically powered surgical tools can also cause disturbances with pacemakers. Patients should obtain permission from their doctors prior to driving a car or operating equipment which may fall into the above category. Although a running car should not interfere with a pacemaker during driving, a patient should not lean over a running engine. Any other concerns and precautions should be discussed with your doctor.

When should the battery be replaced ?

Pacemaker leads and batteries are becoming more efficient so that the battery life of the pacemaker continues to increase even as the size of pacemakers decreases.

A modern pacemaker battery can usually last 7-10 years. When the battery is running low, the pacemaker will send a signal that can be detected by the doctor during a routine office or pacemaker clinic visit. A low battery still has time to be replaced electively. The patient should not have to worry that the battery will die unexpectedly. Since the battery is sealed inside the pacemaker chamber, replacing the battery means replacing the entire chamber.

Pacemakers At A Glance :

A pacemaker is a battery-operated device.
A pacemaker maintains normal heart rhythm when the heart is not beating properly.
Pacemakers can be temporary or permanent.
A permanent pacemaker is a small case that can be implanted safely under the skin near the shoulders.
A permanent pacemaker corrects the symptoms caused by abnormally slow heart rates, and allows the patient to enjoy normal living.
Permanent pacemakers should be checked for proper functioning and battery levels periodically.
Modern pacemakers are well protected from most electrical appliances.

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