Most people don’t spend much time thinking about their heartbeat. It simply does its job day and night and isn’t something we pay attention to. But when the heart starts beating too slowly or the electrical signals that control it stop working properly, it can affect how you feel and how well your body functions.

If this happens, a pacemaker may help. A pacemaker is a small device placed under the skin of the chest that helps keep the heart beating at a healthy rate and rhythm. While not everyone with a slow heart rate needs one, some people can benefit greatly from this treatment.

What Does a Pacemaker Do?

Your heart has its own electrical system that tells it when to beat. Sometimes those signals become delayed, blocked or too slow. When that happens, the heart may not pump enough blood to meet your body’s needs.

A pacemaker monitors your heartbeat and sends small electrical signals to the heart when needed. These signals help keep the heart beating at a steady pace.

Signs You May Need a Pacemaker

If your heart is beating too slowly (called bradycardia) and not pumping enough blood, you may notice symptoms such as:

• Feeling tired all the time
• Dizziness or lightheadedness
• Fainting or near-fainting episodes
• Shortness of breath
• Trouble exercising or being active
• Chest discomfort
• Difficulty concentrating or feeling confused
• Heart palpitations or an irregular heartbeat

These symptoms can have many causes, but they are often signs that you may need a pacemaker.

Who Is Most Likely to Need a Pacemaker?

Pacemakers are often recommended for people with certain heart rhythm disorders. Some of the most common reasons include:

• Bradycardia, or a slow heartbeat
• Heart block, which occurs when electrical signals cannot travel normally through the heart
• Problems with the heart’s natural pacemaker, called the sinus node
• Certain heart conditions that develop after a heart attack
• Some congenital heart defects
• Situations where medications needed to treat heart disease slow the heart too much

Your healthcare provider may order tests such as an electrocardiogram (ECG), heart monitor or other evaluations to determine whether a pacemaker is needed.

What Is Pacemaker Surgery Like?

Many people are surprised to learn that pacemaker implantation is usually a relatively routine procedure. The device is typically placed under the skin near the collarbone through a small incision and the procedure often takes less than an hour. Some patients go home the same day, while others stay overnight for observation.

Recovery is generally quick. Most people can return to many normal activities within a few days, although heavy lifting and strenuous activity may be limited for a short time.

When Should You Talk to Your Doctor?

If you frequently feel dizzy, unusually tired or short of breath, don’t assume it’s simply part of getting older. These symptoms may signal a heart rhythm problem that deserves attention.

A pacemaker isn’t necessary for everyone with a slow heart rate. But for people whose symptoms are caused by an abnormal heart rhythm, it may improve quality of life and help the heart work more efficiently.

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