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Cardiac Pacemaker

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Kendall Hockley

on 23 June 2014

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Transcript of Cardiac Pacemaker

62
ECG
bpm
Thank You!
What is a Cardiac Pacemaker?
A cardiac pacemaker is a small device that is implanted under the skin in the chest (just under the collarbone) or abdomen to help abnormal heart rhythms by using electrical pulses to prompt the heart to beat at a normal rate, some pacemakers now record your blood temperature.
The cardiac pacemaker helps assist, monitor and control your heartbeat. The pacemaker contains a battery that last six to ten years, a pulse generator and a tiny computer circuit that converts its energy from the battery into the electrical impulses. The pacemaker is connected to your heart by one or more wires
The average hospital stay for artificial cardiac pacemaker implantation is between one to two days. The procedure is usually done under local anaesthesia, the pulse generator is the size and weight of three 50 cent coins, which is implanted under the skin just below the collarbone. The leads are inserted using x-ray control via a vein found in that proximity, then position in right-sided heart chamber. The leads are tested before the pulse generator is attached.
Historical Development
• It was the research done by Dr Wilfred Bigelow and Dr John Callahan in the 1940’s that lead to the accidental discovery of a pacemaker. They discovered that by lowering the body’s temperature caused the heart to beat slower. Whilst experimenting on a dog they discovered that an electrical pulse could start the heart again. In 1950 an electrical engineer John Hopps was hired to build the pacemaker. It was a large device about 30cm long which used vacuum tubes to generate an electrical pulse.
• The late 1950’s and early 1960 saw the technological development of silicon transistors and batteries, which resulted in the pacemakers becoming small enough to now be implanted into a human.
• 1970’s saw pacemakers powered by nuclear energy and then further developments lead to the use of lithium ion batteries which are still used today in pacemakers.
• Today pacemakers are smaller and last longer. They are the size of a USB stick with a microprocessor which collects relevant data.



How it works
By Kendall Hockley Yr 12 CAFS
Cardiac Pacemaker
Political Impact
The government helps fund for pacemakers. All pacemakers are tested before they are implanted into a patients for safety reasons. The government regulates the production and manufacturing of pacemakers to ensure they are constructed with safe a suitable materials and perform at a high standard to guarantee the safety of all patients. The doctors that implant the cardiac pacemaker don’t take things lightly due to the costs involved which is why there is a process that goes through checklists and paperwork.
Economic Impact
The average cost of the pacemaker is $35,000-$45,000. The financial benefits of having this technology is less time spent in hospital. Patients that are with the public health fund may have to wait longer and go through a lengthier process, where as being a patient under a private health fund would have their choice of doctor and waiting periods would be shorter.
Religious Impact
The use of pacemakers brings about end of life issues that causes concerns for some religious groups but you do need permission off the priest to turn the pacemaker off when the person dies. Pacemakers may save lives but it should not come at a cost of someone not having a peaceful death. It is important that patients with a pacemaker, discuss with their family their wishes for when this device should be deactivated. Such devices create a moral mind field for patients and their doctor as eventually they will be faced with the question do I turn it off?
Groups using this technology
A pacemaker is not restricted to any age, anyone is eligible to get one. Some of the purposes for this technology are; Genetic heart condition, irregular heartbeats, coronary heart disease, heart attack, heart failure, stroke and arrhythmias.
This cardiac pacemaker does create some barriers to access for all groups but the main ones are; Rural and low socioeconomic status. Location is the main barrier for the rural community receiving a cardiac pacemaker. People who live in rural areas are further from larger hospitals who perform the specialised surgery and are also further from heart specialists whom look after their care. Travelling long distances for such services can make this device not as accessible for rural communities.
Lower socioeconomic groups such as Aboriginal and Tores Strait Islander people may also have difficulty accessing this device due to poor education, location and a lower access to health care.
Issues related to use and development

When you have a pacemaker you have limitation to short term and long term things. Limitations may include; running, high impact sports, skydiving and airport security gates. Many of these limitations effect the physical and social wellbeing due to not being involved in many activities anymore. Every six to ten years patients need to visit the hospital and go under surgery to replace the battery.

Social Impact
Many people use this piece of technology for a variety of different reasons such as; Genetic heart condition, irregular heartbeats and heart disease. A pacemaker does limit you with socialising, for example; if you are in a sporting group and you have a pacemaker you will no longer be able to play that sport due to the restrictions your heart has, which limits not only your physical wellbeing but also your social wellbeing. Patients that have a cardiac pacemaker may have an impact on their social interactions due to anxiety, stress and nervousness which can cause a negative impact on the patient’s social wellbeing.
first practical pacemaker was designed by John Hopps.
It was an external device powered by ac with a
small electric lead implanted into the heart. Main problems were
immobility and power black outs.

Dr Rune Elqvist developed the nextmodel which was powered by a battery. This gave freedom of movement.

An engineer Wilson Greatbatch
implanted the first successful
pacemaker into a human.
leads were connected to their
heart through the veins which
meant the chest cavity did not
have to be opened up
The dual chamber pacemaker
was created. This was more expensive
than the single chamber pacers.

With our population aging the demand for pacemakers grew.Pacemakers contain microprocessors which record a lot of data about the heart and smaller in size.

The discovery that electrical
beat impulses cause the heart to beat
American physiologist Albert Hyman built the
first artificial pacemaker powered by a hand cranked
motor. This was only tested on animals.

powered by a hand cranked
The introduction of the lithium iodide
battery extended the battery life of a
pacemaker from 12mths to nearly 10yrs.

Early 1800's
1932
1950
1957
1960
1975
1980's
1990's-
Present (now
Full transcript