A pacemaker is a small, battery-operated medical device that regulates the heart’s rhythm. It helps maintain a steady heart rate when the heart’s natural electrical system malfunctions, causing beats that are too slow, too fast, or irregular. The device ensures the heart pumps blood effectively, preventing symptoms like dizziness, fatigue, or fainting. A pacemaker can improve a person’s quality of life by stabilizing abnormal heart rhythms.
Understanding Pacemaker Function and Placement
A pacemaker works by sending low-energy electrical pulses to the heart, stimulating the heart muscle to contract and maintain a normal rhythm. The heart has its own electrical system, with a natural pacemaker called the sinoatrial (SA) node that generates electrical signals. When this natural system malfunctions, the implanted pacemaker takes over, using electrodes to sense the heart’s activity and deliver impulses as needed.
Traditional pacemakers consist of a pulse generator, which contains the battery and electronic circuits, and wires called leads. These leads are inserted into a vein near the collarbone and guided to the heart chambers, where their tips are attached. The pulse generator is then placed in a small “pocket” created under the skin, usually in the upper chest. Newer leadless pacemakers are smaller and are placed directly inside a heart chamber without wires.
Permanent Physical Activity Limitations
After pacemaker implantation, certain physical activities require permanent caution or restriction to protect the device and its leads. Direct impact to the pacemaker site should be avoided. This includes contact sports like football, rugby, or martial arts, where blows to the chest are common. While protective padding may be recommended for some sports, high-impact activities generally remain restricted.
Activities involving vigorous or repetitive overhead arm movements on the side of the implant should be approached with care. Activities like swimming, tennis, or golf can increase the risk of lead damage over time. Heavy lifting, particularly weights over 10 pounds, pushing, pulling, or twisting motions, should be avoided or performed with caution to prevent putting pressure on the implantation site or dislodging the leads. Patients can return to an active lifestyle, but these considerations remain for the device’s lifetime.
Permanent Environmental and Device Avoidance
Individuals with pacemakers must be mindful of certain environments and devices due to potential electromagnetic interference (EMI). Strong magnetic fields or electrical signals can temporarily affect a pacemaker’s function, potentially causing it to malfunction or deliver impulses irregularly. This interference can lead to symptoms like changes in pacing rate or even a brief pause in function, especially for patients dependent on the device.
Common household items such as microwave ovens are generally safe, but it is advisable to maintain a safe distance. Cell phones and smartwatches should be kept at least 6 inches (about 15 cm) away from the pacemaker site. This means they should not be carried in a shirt or jacket pocket directly over the device. When using a cell phone, hold it to the ear opposite the side of the pacemaker.
Security systems, including airport scanners and anti-theft detectors in stores, warrant caution. While full-body scanners at airports are generally considered safe and do not typically interfere with pacemakers, walk-through metal detectors and hand-held wands can potentially cause temporary interference. Inform security personnel about the pacemaker and avoid lingering near these systems; always carry a medical device ID card.
Certain medical procedures pose a risk due to strong magnetic fields or radiofrequency energy. Magnetic Resonance Imaging (MRI) scans were historically contraindicated for pacemaker patients because strong magnetic fields could disrupt or damage the device. However, many newer pacemakers are “MRI-conditional,” meaning they can undergo MRI scans under strict protocols and careful monitoring. Diathermy, a medical procedure using high-frequency electrical currents for therapeutic heating, is generally contraindicated for pacemaker patients due to interference risk. Industrial equipment, such as large motors or power-generating machinery, can also produce strong electromagnetic fields, necessitating caution and maintaining a safe distance.