Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about pacemakers. And you can find written notes on this topic at zero tofinals.com

slash pacemakers or in the cardiology section of the zero to finals medicine book.

So let's get straight into it.

Pacemakers deliver controlled electrical impulses to specific areas of the heart

to improve the heart function.

They consist of a pulse generator, which is the pacemaker box, and then the pacing leads, which is what carries

the electrical impulses to the relevant parts of the heart. The box is implanted under the skin,

most commonly in the left anterior chest wall, just below the clavicle. The wires come out of the

box, run under the skin, and then they go into

the left subcalavian vein, and then through the venous system, into the relevant chambers

of the heart. Patients with a pacemaker are followed up regularly to download information

from the pacemaker, check everything's working okay and decide if

the battery needs replacing. They get given an identity card and also a bracelet that alerts

emergency services in the event of an emergency. Pacemakers do not interact with most

day-to-day electrical activities.

However, they may be incompatible with MRI scanners due to the powerful magnets,

Tens machines which are used for pain management, and diathermy used during surgical procedures.

Many modern pacemakers are MRI-compatible, meaning the patient can still have MRI scans.

It's worth noting that some smartphones may interact with pacemakers if they're held too close,

and devices with strong magnets, for example handheld security scanners used at airports, can also

affect the pacemaker function.

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