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A pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate or to stimulate the lower chambers of the heart. Pacemakers are used to treat patients with slow heart rhythms that may occur as a result of disease.
Conventional pacemakers consist of a pulse generator, which is implanted below the skin in a surgical “pocket” near the collarbone, and leads, which are thin wires extending from the pulse generator through a vein into the heart to deliver electrical impulses.
A leadless pacemaker is much smaller. The entire device—essentially a computer chip paired with a small but long-lived battery—is placed directly in the heart.
The pacemaker is put in place using a long, thin tube called a catheter. The catheter is inserted into the femoral vein through a very small incision in the groin after numbing that area with local anesthetic. The doctor uses an X-ray machine to guide the catheter to the heart. Once the catheter is inside the right ventricle, the doctor will use it to put the pacemaker into place. Then, the catheter is removed and the incision site is closed. This procedure typically takes just 30 minutes or so.
Because the leadless pacemaker does not require implant surgery like a traditional pacemaker, the procedure is less invasive and has a much lower rate of long-term complication. There is no lump under the skin, which can sometimes cause minor discomfort. The patient does not need to limit upper body activity, as is the case with a conventional implant. Also, there is virtually no scar left behind.
Not everyone is a candidate for a leadless pacemaker. Currently, the device is available only for patients with certain medical conditions and a slow heart rate who need single-chamber pacing only. Your doctor can tell you if you are a candidate for a leadless pacemaker after a review of your medical history, heart rhythm, and the results of medical tests.