Pacemaker Corrects Abnormal Heart Rhythm

Gerry Green, 70, of Durham, had put up with a lack of energy for years, but in the last year, the problem became debilitating. “I’d gotten to where I would get up, have breakfast and then go back to bed for two hours,” he said. “I’d get up for lunch and then want another nap. My wife figured I was sleeping 16 hours a day.” 

Green, a retired employee benefits consultant, wasn’t depressed and, aside from occasional headaches and dizziness, he felt fine—just worn out. At his yearly check-up last summer, his doctor discovered the reason for his unusual fatigue: Green had an abnormally low heart rate, called bradycardia, which can deprive the body’s organs and tissues of oxygen-rich blood. He also had an erratic heart rhythm, or arrhythmia. 

Fortunately Green’s problems had a solution. Dr. Tim Donahue, MD, a heart rhythm specialist at Triangle Heart Associates, recommended a pacemaker. Several weeks after his physical, Green went in for the outpatient procedure. 

Doctors treat a variety of rhythm disorders at the clinic’s electrophysiology lab. “Some people’s rhythms are too slow; others are too fast,” said Donahue. “Patients whose heart rate is too slow may need medication or a pacemaker. For patients whose heart rate is too fast, we may put in a defibrillator.” Some problems can be corrected with ablation, in which doctors burn or scar tissues that are the source of the heart’s abnormal rhythm. 

“We sit down with people, discuss their options and try to figure out which option is best for them,” said Donahue. Most procedures can be done without a hospital stay. “Some 90 to 95 percent of patients go home the same day,” he said. 

While Green was under sedation— similar to what is used when a colonoscopy is performed—Donahue cut a “pocket” in Green’s chest near the collarbone, then threaded wires through the blood vessels and fixed them to the interior wall of the heart. Then the pacemaker was slipped into place. A few hours after the surgery, Green was home, his heart beating normally. 

The device monitors Green’s heart rate and generates electrical impulses as needed to maintain an appropriate rate. The unit can be replaced every five to 10 years when the battery wears out. 

Green had expected to feel better post-surgery, but was shocked at how fast his symptoms vanished. “I haven’t had a nap since I woke up from the procedure,” he said. “I sleep eight hours a night and I’m ready to go.” 

What to do with all the new time in his schedule? “I don’t have any specific goals other than enjoying being able to participate in each day rather than sleeping it away,” Green said. “Duke has given me a new lease on life.”