When the heart’s natural rhythm slows down or becomes irregular, a pacemaker may be needed to help it maintain a steady beat. These small, battery-powered devices are implanted under the skin and connected to the heart with wires (leads) to deliver electrical impulses that regulate the heartbeat.
But not all pacemakers are the same. There are several types, each designed to support different heart conditions. If your physician has recommended a pacemaker, you may be wondering which type you need and how that decision is made.
Let’s explore the primary types of pacemakers, how they function, and what doctors consider when choosing the right one for a patient.
What Do Pacemakers Treat?
Pacemakers are typically used to treat bradycardia (a heart rate that is too slow), heart block (delayed or blocked electrical signals), or irregular rhythms caused by atrial fibrillation. Some devices are also used in heart failure patients to coordinate contractions between the heart’s chambers.
The goal of a pacemaker is to ensure that the heart maintains a rhythm that is strong and consistent enough to deliver oxygen-rich blood throughout the body.
The Three Main Types of Pacemakers
1. Single-Chamber Pacemaker
A single-chamber pacemaker has one lead placed in either the right atrium or right ventricle, depending on the specific condition.
- Who It’s For:Most often, single-chamber pacemakers are used for patients with atrial fibrillation who also have slow ventricular response or for patients with certain types of heart block.
- How It Works:It monitors the heart’s rhythm and sends an electrical signal when the rate drops below a set level. This signal stimulates the atrium (or ventricle) to contract.
2. Dual-Chamber Pacemaker
This device has two leads: one in the right atrium and one in the right ventricle. The pacemaker coordinates the timing between the two chambers so they beat in a natural sequence.
- Who It’s For:Dual-chamber pacemakers are commonly used in patients with atrioventricular (AV) block or sick sinus syndrome.
- How It Works:The device ensures that the atrium contracts first, followed by the ventricle, to preserve the heart’s natural pumping action.
3. Biventricular Pacemaker (Cardiac Resynchronization Therapy, or CRT)
This more advanced type has three leads: one in the right atrium, one in the right ventricle, and one in the left ventricle via a vein on the heart’s surface.
- Who It’s For:Biventricular pacemakers are used in patients with heart failure who have delayed electrical activation between the right and left sides of the heart.
- How It Works:By stimulating both ventricles to contract at the same time, CRT improves the heart’s efficiency and can reduce the symptoms of heart failure.
How Do Doctors Decide Which Pacemaker You Need?
Selecting the right type of pacemaker depends on several clinical factors, including:
- Heart Rhythm Diagnosis:Your exact rhythm disorder guides the type of device.
- Symptoms and Severity:Fatigue, fainting spells, or exercise intolerance may signal the need for more advanced pacing.
- Heart Structure and Function:Imaging studies and diagnostic tests help determine whether the heart’s chambers are properly synchronized.
- Age and Overall Health:The decision may also be influenced by other medical conditions, life expectancy, and how well a patient is likely to tolerate the procedure.
Before implantation, patients typically undergo tests such as an electrocardiogram or echocardiogram or wear a Holter monitor to evaluate their heart rhythm and determine pacing needs.
Personalized Cardiac Care for Your Rhythm Needs
The physicians at Houston Physicians Hospital specialize in diagnosing and treating rhythm disorders with the appropriate types of pacemakers. Whether you need a single-chamber, dual-chamber, or biventricular device, expert cardiac care is available to help restore and maintain your heart’s natural rhythm.
On the Heart and Vascular Center of Excellence page, you can scroll down and find a physician who’s right for you. Then click their bio to visit their website and make an appointment.