Cardiac Rhythm Therapy Patient's Manual What You Need to Know about Your

What You Need to Know about Your Pacemaker www.biotronik.com

The Heart and Malfunctions of the Heart 6 Living with a Pacemaker 25 Returning to a Normal Life 26 Answers to Freguently Asked Questions 34

Introduction You are now among the more than two million people in the world who have a pacemaker. In the past, a pacemaker's only purpose was to save lives. Today, patients gain a new quality of life. Many of them are able to work in their profession again, to manage their household, to travel, and to engage in athletic exercises. In other words: These people again live the life they were used to. This manual provides you with useful information about the heart and pacemakers. Your primary physician or cardiac specialist will be glad to answer any additional questions that you might have. BIOTRONIK®...

The Heart and Malfunctions of the Heart The heart is a fist-sized hollow muscle consisting of four chambers. The two atrial chambers (atria) form the upper half of the heart, the two main chambers (ventricles) the lower half. A wall (septum) divides the heart into a right and a left side. The heart muscle pumps blood through the body by contracting and expanding regularly. This ensures a sufficient supply of oxygen and nutrients to various tissues and organs of the body. To gather the blood and pump it into the circulation systems, the heart must be stimulated by small intrinsic electric pulses,...

Lung Body Oxygen-enriched blood Oxygen-depleted blood A healthy heart in the center of the bloodstream 6|7

Via the cardiac conduction system, the electric pulse travels through cardiac tissue to cause the chambers to contract and pump the blood into the circulatory system. A healthy heart beats between 60 and 80 times per minute, equivalent to about 100,000 heartbeats each day. During physical exercise or under emotional stress, the body needs more oxygen. To respond to these changed conditions, the heartbeat can increase to more than 100 beats per minute. Malfunctions of the heart can be traced to a number of causes. For example, cardiac disease or the aging process can interfere with the heart‘s...

Sinus node AV node Bundle of His Purkinje fibers The cardiac conduction system of the heart The consequence of these pathological phenomena can be an irregular or slowed heartbeat. In such cases, the body is – especially under physical stress – not supplied with enough oxygen, which can lead to dizziness, fatigue, or faintness. The medical term for these kinds of rhythm disturbances is bradycardia. 8|9

Two common bradycardic arrhythmias are the sick sinus syndrome and AV block. With sick sinus syndrome, the function of the sinus node is disturbed; electric pulses are generated irregularly or too slowly. Especially under stress, the heart is then no longer capable of adjusting the heart rate to the increased demands. With AV block, the conduction of the electric signals of the sinus node through the AV node into the ventricles is disturbed. If the conduction between atrium and ventricle is completely interrupted, we speak of a total AV block. In response, additional electric centers in the heart...

With the help of a pacemaker system, carefully calibrated electric pulses stimulate the heart muscle in such a manner that the heart rhythm is once again similar to that of a healthy heart. 10 | 11

The Pacemaker Modern pacemaker systems can be adapted to any specific malfunction of the heart. They consist of the pacemaker and the leads connected to it. The pacemaker contains miniaturized electronic circuitry and a battery. It becomes active whenever the patient exhibits a disturbed heart rhythm. For this to happen, the system must be able to detect the heart's intrinsic activity. When the pacemaker sends an electric pulse, the heart muscle contracts. The connection between pacemaker and heart is established by one or two leads. A lead is a very thin, electrically insulated wire that is...

Transparent connection head part (header) Especially long-lasting battery Electronic circuitry Biocompatible titanium housing The pacemaker The leads detect the cardiac activity, transmit this information to the pacemaker, and send the electric pulse to the heart. Depending on the therapeutic requirements, single-chamber or dual-chamber pacemakers can be implanted. The terms relate to the pacemaker's feature of pacing and sensing intrinsic activities in

either one or both chambers. In a dual-chamber system, one lead is usually positioned in the atrium, and another one in the ventricle. Thus, the activities of the two chambers are synchronized, and optimal contraction of the heart muscle is

The dual-chamber pacemaker Many pacemakers are capable of automatically adapting the rate, with which they send out electric pulses, in response to changing needs and activities of the patient. Such so-called rate-adaptive functions of pacemakers are possible due to special sensors in the pacemaker that react to changed conditions. Changed physical needs, as they are created, for instance, by running, swimming, or gardening, are compensated for by the pacemaker with an increasing heart rate.

The latest generation of BIOTRONIK pacemakers is also capable of reacting to changed emotions. For example, if you watch a very thrilling movie or something unexpected surprises you, your heartbeat may speed up – and your blood pressure rises. The Closed Loop Stimulation system, a special feature of some pacemakers, allows adjustment even to such forms of emotional stress. The wide range of BIOTRONIK products enables the physician to diagnose cardiac rhythm disturbances correctly and to treat them safely. Thanks to intensive research, these pacemakers stand for the current state of technological...

Hans M., born in 1932, pensioner from Berlin, retired cardiologist

“As a physician, I used to implant pacemakers myself. Later, when I experienced the same symptoms as my former patients and had an ECG recorded by my successor, my suspicion turned into certainty: I needed a pacemaker. Since I have had the device, I have not fainted once. I feel fit and awake again. And to my great joy, I can be active in my rowing club again.” 18 | 19