A pacemaker is an electrically charged medical device. Your surgeon implants it under your skin to help manage irregular heartbeats called arrhythmias. Modern pacemakers have two parts. One part, called the pulse generator, contains the battery and the electronics that control your heartbeat. The other part is one or more leads to send electrical signals to your heart. Leads are small wires that run from the pulse generator to your heart. Pacemakers generally treat two types of arrhythmias: Tachycardia, a heartbeat that’s too fast Bradycardia, a heartbeat that’s too slow. Before receiving a pacemaker, you’ll need several tests. These tests can ensure that a pacemaker is the right choice for you. An echocardiogram uses sound waves to measure the size and thickness of your heart muscle. For an electrocardiogram, a nurse or doctor places sensors on your skin that measure your heart’s electrical signals. For Holter monitoring, you wear a device that tracks your heart rhythm for 24 hours. A stress test monitors your heart rate while you exercise.

2.  Definition of pacemaker
 Types of pacemaker
 Why do we need it
 Complications
 Nursing intervention

3.  Cardiac pacemaker is a medical device which
provide support to the pace generating
system of heart incase of inadequate
functioning of heart pace generating system.

4. Sinoatrial node
AV Node
Bundle of His
Bundle branches
Purkinje fibers

5.  Temporary pacemaker
 Permanent pacemaker

6. It is apply on patient for short duration
externally

7.  Pacemaker which need to be implanted for
long time,for those suffering from chronic
pace generation problem.

8.  Whenever SA Node andAV Node are not able
to generate impulses.

9.  Local infection at the entry site of the leads
 Pneumothorax and hemothorax
 Bleeding and hematoma at the lead entry site
 Dislocation of the lead placed.

10.  Failure to pace occurs when the pacemaker
fails to initiate an electrical stimulus,is noted
by absence of pacer spikes on the rhythm
strip.
 Failure to capture occur when the pacemaker
generates an electrical impulse and no
depolarization is noted. On ECG, a pacer
spike is noted,but is not followed by P wave
or QRS complex.

12.  The battery and security of connections of
temporary pacemakers shall be checked every
shift and documented in the patients record.
 The ECG is monitored very carefully to detect
pacemaker malfunction.
 Monitor especially the heart rate,because the
patient experiencing pacemaker malfunction
may develop Bradycardia.
 Assess symptoms include chest pain, shortness
of breath and hypotension.

13.  Advice the patient to place cellular phone at
leat 6-12 inches away from the pacemaker.
 Magnets and large stero speaker shouldn’t be
near the pacemaker longer than few second.
 For the first few weeks after receiving your
pacemaker,don’t raise your arm.
 Don’t do arm exercises.
 Sings of pacemaker malfunction to report
include chest pain,weakness,dizziness.