Study note
MedicineCardiology

Permanent pacemakers: components, leads and programming

THE CONTEXT
Permanent pacemakers are small, flat metal devices implanted beneath the skin, usually in the pectoral area.

Device and lead placement

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The device contains a battery, pulse generator and programmable electronics that allow adjustment of pacing and memory functions.
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Leads can be introduced through the subclavian or cephalic veins into the right ventricle or right atrial appendage.
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Leads may be placed in both chambers to maintain atrioventricular (AV) synchrony.

Programming

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An external programmer controls the pacemaker through wireless telemetry.
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Rate, output, timing and other parameters can be adjusted to tailor the device settings to the patient's needs.
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