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Everything there is to know about rhythmology

Why are we suggesting implanting a pacemaker? You present (or risk presenting) symptoms. A certain number of tests have been carried out. Resorting to a pacemaker has been recommended. This decision has been taken collectively with the help of your attending GP or cardiologist. Under normal circumstances, in order for the cardiac muscle to contract, a network of electric cells creates and distributes the electrical current/impulses to the whole myocardium as it depolarizes. It is, so to speak, the "ignition" of your heart. When it does not function well, your heart "stalls". Grossly speaking, there are two types of conduction disorders: - The first one relates to the birth of the electrical current itself. The heart becomes "electrically lazy" and the sinusal knot artery from which the electrical current spreads does not play its role any more. - The second one is due to the fact that the current does not spread from the sinusal knot to the rest of the heart. Many reasons can affect the electrical functioning of the heart. The most frequent is naturally ageing. As time goes by, the conductive properties change. This phenomenon is perfectly normal, but not everyone is affected in the same way. That is why someone might develop a conduction disorder at the age of 60 while someone else who is older might never be affected.

Other causes can create or accelerate these phenomena. The main "acquired" cause is the myocardial infarction. When a nutrient artery gets obstructed, the whole or part of the zone it vascularizes dies. This can lead to a dysfunctioning of the electrical network/ heart conduction disease. The medicine your doctor prescribes can also result in electrical disorders. If they have to be prescribed for your well-being, implanting a pacemaker might be recommended to counter their side effects. Some heart conditions (whether they be infectious, toxic or metabolic) can trouble/affect/ impact on the electric heart network. When there are electrical conduction disorders (abnormalities/defects), we need to create normal working conditions for the heart. As things stand at present, we can't repair the existing electrical system. There is not even a drug which could improve the functioning of a failing network. The only therapeutic alternative is setting a prosthesis which compensates the dysfunction: the pacemaker. Read more: how did we reach a diagnosis?

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