August 2006, Volume 36 Number 8 , p 50 - 54
COTTER, JOHN RN, APRN, BC, CCRN, MS; BIXBY, MARCIA RN, APRN, BC, CCRN, MS; MORSE, BELINDA RN, MSN
Here's what you need to know to guide your cardiac patient through diagnosis and implantation and back into an active life.
YOUR PATIENT MAY NEED a permanent pacemaker if he has cardiomyopathy or a rhythm disturbance, especially if it reduces cardiac output. In this article, we'll describe how pacemakers work, when they're indicated, and what you need to know about caring for a patient with a pacemaker.
How a pacemaker works
A permanent pacemaker consists of a pulse generator and one to three pacing leads. The battery-operated pulse generator is implanted in a subcutaneous pocket in the patient's upper chest or abdomen. The leads—catheters with electrodes at the tips—are threaded through the subclavian vein to the heart. In a two-lead system, the tip of one lead lies in the right atrium; the tip of the second lead lies in the right ventricle. These leads deliver the impulse ...