ABSTRACT
Pacemakers were first introduced in 1958 by Senning as a treatment
for complete heart block. They now have much wider applications.
The system consists of a battery operated generator (pacemaker) and
electrodes (leads) which stimulate the heart. Pacemakers are inserted
under local anaesthesia. The electrode is placed into the right
ventricle and or right atrium, either by cutting down on a cephalic
vein or by subclavian Seldinger technique. The position of the
electrode is checked radiologically. Electronic parameters are obtained
and need to be entirely satisfactory. A subcutaneous pocket is then
created to position the generator. Very rarely, when venous systems
prove inadequate, an epicardial approach is required, using a
corkscrew electrode, through a small thoracotomy. The tip of the
electrode (which makes contact with the myocardium) can be
unipolar or bipolar.
