Medical opinion: Cardiac pacemakers work to prolong life

Editor's note: Board-certified specialists from a panel of Yuma-area physicians provide to-the-point answers to questions submitted by Sun readers. The answers are only the opinions of the answering physicians and are not meant to be a substitute for medical consultation or physician care. Submit questions by e-mail to medicalopinion @yahoo.com or via regular mail at Yuma County Medical Society, P.O. Box 4476, Yuma 85366.


Q — My elderly father has been advised to have a pacemaker. Are there more than one kind and is it a complicated procedure?
 
A — A pacemaker is an electronic gadget that provides an electrical current to heart muscle that is alive but not efficiently contracting or pumping blood.
 
It has developed from this simple function to a sophisticated instrument that reverses death in patients who "fibrillate." This is when the heart muscle contracts continuously but uncoordinated and does not pump blood to the body - a common cause of death in young and old. This process is defibrillation.
 
There is now a process where pacemakers can assist a failing heart by pacing the stronger left ventricle of the heart instead of just the right ventricle. This process can prolong life and improve the quality of life.
 
The technology of pacemakers is a monument to man's imagination. In 1899 a British doctor applied an electrical current to a heart and made it beat. This phenomenon was repeated by others and in 1932 an American physiologist applied a current to a heart and termed it an "artificial pacemaker." Development slowed because the public perceived this as "reviving the dead."
 
External pacemakers applied to the outside of the body were used but these were painful. Open heart surgery developed in the 1950s and caused a disruption of the normal pacing of the hearts. Pacemakers were again pursued and the development of the silicon transistor gave light speed to the development of an implantable pacemaker.
 
The Medtronic pacemaker company came into being. Their pacemakers were large because of the type of battery needed to supply the electrical current. The mode of implanting the pacemaker was by opening the chest and sewing the wires to the heart surface.
 
A new type of battery and new ways of delivery of the electrical current by passing wires through the vein changed the mode of implanting dramatically. From a complicated painful procedure, it became a near "outpatient" procedure.
 
Not only does pacemakers prolong life by making the heart beat in a near normal manner but now the quality of life is improved in people with "heart failure." This is done by stimulating the stronger left ventricle and reduce the strain on the weaker right ventricle.
 
Technological advances in many fields are responsible for the "pacemaker" as we know it today. Considerable information has been left out in the interest of brevity.
 
Call me if you have any questions. Ever hear of the atomic pacemaker?


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Dale F. Webb, M.D., is a former Yuma chest surgeon.