Operations available to treat heart disease and stroke range from relatively minor procedures such as angioplasties and the fitting of pacemakers, to heart transplants. An artificial pacemaker may be needed by patients with heart block or who have irregular heart rates or heart rhythms. The pacemaker has a power supply or batteries and electronic circuitry, weighs about 20 to 50g and is almost completely hidden. They last on average between six and 10 years. Electrical impulses are conducted down the electrode lead to the heart, stimulating heartbeats.
Some pacemakers discharge electrical impulses at a fixed rate, but most work on demand.
The pacemaker may be fitted under local anaesthetic when an electrode lead is inserted into a vein at the shoulder or the base of the neck and guided into the correct chamber of the heart using an X-ray screen. The electrode may alternatively be attached directly onto the outer surface of the heart. The pacemaker box is positioned under the skin of the abdomen. There is a small danger of infection where the pacemaker is fitted. There are around 300 heart transplants carried out in the UK each year.