There are three types of pacemakers:
-Single-chamber: There is only one pacing electrical lead, and it is implanted in the right atrium or ventricle.
-Dual-chamber: Two pacing leads are implanted, one in the right atrium and one in the right ventricle.
-Biventricular pacing: This is used for Cardiac Resynchronization Therapy and has leads placed in both ventricles and one atrium.
There are two ways a pacemaker can be implanted:
--Endocardial, Transvenous approach: This is the most common technique, as it is minimally invasive. In this technique, the pacemaker is placed inside the heart. First, an electrical lead is placed into a vein in the groin or near the collarbone and then guided to the heart. The tip of this lead will be attached to the muscle of the heart and the other end of it will be attached to the pacemaker generator, which is placed in the chest under the skin. The generator is usually placed on the patientÃ¢â‚¬â„¢s non-dominant side through an incision made in the chest.
--Epicardial approach: In this technique, the electrical lead tip is attached to the exterior of the heart instead of inside. As above, the other end of the lead is attached to the pulse generator. However, in this procedure, the pulse generator is placed in the abdomen. This procedure requires general anesthesia, whereas the above approach does not.