Monday, February 25, 2013

Pacemakers and the Pope

     Sadly, the human body wears out over time. But, Pope Benedict XVI’s resignation at age 85 shocked many. After all, he was the first pontiff to do so in nearly 600 years. The exact reasons for the Pope’s resignation remain unclear, but he says his declining strength is holding him back.

     Ten years ago, the Pope underwent a pacemaker implantation. Three months before calling it quits, he received a replacement. Could heart health be the cause of his early retirement? According to cardiologist Joseph Reilly, MD of Hagerstown Heart, a slow heartbeat is commonly related to age and one of the reasons for a pacemaker. “Bradycardia [slow heart rate] can be a progressive condition related to the heart’s aging electrical system,” explains Dr. Reilly.

     With each heartbeat, an electrical signal generates from the top of your heart to the bottom. As the signal travels, it causes the heart to contract and pump blood. “Your heart has electrical wiring just like your house. If there’s a problem at one point of your electrical wiring, you may need a pacemaker,” says Dr. Reilly.

A slow heartbeat 
     Bradycardia occurs when your heart beats too slowly. Because there’s not enough cardiac output to do normal things, you can become winded, tired, dizzy, lightheaded, or even faint. In addition to the heart’s normal age-related changes, cardiovascular disease can also damage the heart’s electrical system and cause Bradycardia. Even medical conditions like an under active thyroid or too much potassium in the blood can slow a heart rate.

Treating Bradycardia
     The average resting heart rate is somewhere between sixty and one-hundred beats per minute, but if your heart is beating under sixty beats per minute, chances are a pacemaker is for you. An electrocardiogram (EKG) helps a cardiologist determine how your heart is functioning.

     Dr. Reilly most often sees people age 65 or older requiring a pacemaker, but his oldest patient was a 103-year-old woman. “She initially refused to get a pacemaker at age 98, but she came back asking for a pacemaker when she could no longer cook breakfast for her great, great grandchildren,” says Dr. Reilly.

Medical marvel 
     A pacemaker weighs about an ounce—the size of a half-dollar piece, or a pocket watch. Its battery and computer circuitry monitors the heart, sending tiny electrical signals to increase its rate if it detects a slow rhythm. Most pacemakers last six to eight years.

     Dr. Reilly, a specialized electrophysiologist, performs pacemaker procedures in the hospital’s catheterization lab. The procedure is done under local anesthesia where the cardiologist makes a small incision under the collarbone to implant the pacemaker. Patients stay overnight in the hospital for monitoring and report back to their cardiologist for an evaluation several weeks later.

Life after a pacemaker
     Once the pacemaker starts regulating the heart, patients don’t feel a thing—but they do feel better. “More than 80% of my pacemaker patients say they have more energy and more mobility,” says Dr. Reilly. Patients check back with their cardiologists several times a year to follow their pacemaker’s functioning.

     Although it’s unlikely that a pacemaker would stop working because of electrical interference, it’s recommended that pacemaker patients seek an alternative to airport metal detectors, avoid MRI scans and place a cell phone on the ear opposite to the pacemaker.

     Despite modern medical advances, only the Pope knows what’s best for him. His new pacemaker will carry him into his nineties, but the rest of his body needs to keep up too. He wouldn’t be the first to spend his golden years out of the public spotlight.

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