Medically Reviewed by Prabal K. Guha, MD

Implanting a pacemaker to keep a heartbeat steady and regular is a common heart procedure. But how do you know if you need one? McLeod Electrophysiologist Dr. Prabal Guha explains how patients are evaluated for a pacemaker.

Here’s an overview of Dr. Guha’s  explanation:
The most common symptom that people usually notice is that they start getting tired. Even the regular activity starts making them feel fatigued. They start getting dizzy. Sometimes the heart can stop and a person passes out or feel as if they might. Sometimes it’s excessive shortness of breath. They start exercising but the heart rate doesn’t speed up as it should. The person starts feels short of breath and dizzy. These are the patients who should be evaluated for a pacemaker.

When I see a patient with these problems and suspect that there might be a heart rhythm issue, I put them on a portable heart monitor. That’s a small device (about the size of a cell phone) with small wires or patches attached to the skin. It monitors the heart rhythm continuously for several days. Based on the results, we can see whether the patient needs a pacemaker. We might also have them take an electrocardiogram to confirm our diagnosis.

Occasionally, a person will be undergoing some other testing, such as a colonoscopy. They walk in, tell the doctor that they are dizzy. They are referred to a cardiologist or electrophysiologist and we determine if the heart rate is too slow.

People can have concerns that pacemakers may limit what they can do. It’s just the opposite. Once a pacemaker is implanted and healed, a person can have a completely normal life. I have patients, who have gone back to hunting, fishing and sports. Other patients have gone back to their business or their practice as a lawyer or doctor. They do not have to interrupt their life at all. Most people feel much better after getting a pacemaker.

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