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Advanced Pacemakers

An advanced pacemaker is a device implanted in the chest of patient to regulate heartbeat. Advanced pacemakers are able to sense any irregularities in the heartbeat and correct them with electrical stimulation. They are also responsive to activities in the patient, such as exercise and rest.

The two-way communications system in these devices allows doctors to make adjustments from outside the body, further tailoring each advanced pacemaker to a patient's individual needs. Doctors use an external programming unit called a telemetry transceiver to set the pacemaker and to receive feedback about the activity in the patient's heart and the performance of the pacemaker itself.

What makes an advanced pacemaker "advanced" is the fact that it can sense and respond to the heart of an individual patient. Older model pacemakers simply stimulate the heart to beat at a predetermined rate.

Single-Lead Advanced Pacemakers

Single-lead advanced pacemakers have one lead, which can be implanted in the atrium or the ventricle. Situations calling for single-lead pacemakers include:

chronic atrial fibrillation (lead placed in ventricle)
occasional and brief slow rhythm (lead placed in ventricle)
problems with the formation of initial impulse in the atrium (lead placed in right atrium).

Dual-Chamber Advanced Pacemakers

Some patients have heart rhythm problems occurring in both the atrium and ventricle areas. Dual-chamber pacemakers have two leads to help regulate the heart in these situations. One lead is placed in the right atrium and the other in the right ventricle. This placement of leads helps the upper and lower chambers of the heart to contract in proper sequence.

Advanced Pacemakers and the Aerospace Industry

Space exploration has had great benefits for heart patients here on earth. Much of the technology for advanced pacemakers was developed by NASA.

Astronauts who spend long periods of time in space often develop problems with their hearts and blood vessels. This was the motivation for NASA scientists to find ways to use aerospace technology for heart health. Some innovations that led to the development of the advanced pacemaker include:

Bidirectional telemetry, the technology developed by NASA for two-way communication with satellites, enabled advanced pacemakers to respond to both the doctor and the cardiac activity of the patient.
Microminiaturization technology from NASA was used to create the first single-chip pacemaker.
Technology developed by NASA for the power systems of spacecraft led to the first rechargeable long-life pacemaker battery.

Advanced pacemakers from aerospace technology have had a huge impact on economic growth as well as health care. Sales of Pacesetter, Guidant, Intermedics and Medtronic advanced pacemakers have totaled in the billions and continue to grow annually.

Implanting Advanced Pacemakers

Because of advances in miniaturization, inserting or implanting a heart pacemaker can generally be completed in an hour or less and is considered a minor surgery. Here are the basic steps of implanting advanced pacemakers:

Most of the time, the patient is awake and only local anesthesia is used.
A small incision is made and a pocket is created in the area over the chest wall muscle.
An X-ray tube is used to see the heart and leads so that they can be placed properly. The leads are tested.
After inserting leads in the pulse generator, they are tightened with a special medical screwdriver and the pulse generator is secured to the muscle underneath. The wound is then closed.

Pain after surgery can usually be managed with only aspirin, acetaminophen or ibuprofen.

Resources

HeartPoint Gallery (1997). Pacemakers. Retrieved January 22, 2008, from the Heartpoint.com Web site: http://www.heartpoint.com/pacemakers.html.

NASA Aerospace Technology Innovation (1998). Space Technology Detects, Treats Heart Disease. Retrieved January 22, 2008, from the NASA Web site: http://ipp.nasa.gov/innovation/Innovation62/heart.htm.

United States Space Foundation (1997). Aerospace Technology Spinoffs. Retrieved January 22, 2008, from the Seds.org Web site: http://seds.org/technology/software/ussfspn.pdf.

WiseGeek.com (n.d.). What is a Pacemaker? Retrieved January 22, 2008, from the WiseGeek.com Web site: http://www.wisegeek.com/what-is-a-pacemaker.htm.

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