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CARDIAC PACEMAKERS The heart is bestowed with a specialized system that automatically generates rhythmic control via the sinus node located in the superior lateral wall of the right atrium near the opening of the superior vena cava The specialized pacemaker cells dictate control of the rest of the heart through regular electrical impulses that propagate from the right atria to the lower ventricles The rapid conduction of these impulses cause the muscle cells of the atria to contract and squeeze blood into the ventricles which contract and force blood into the aorta and pulmonary arteries Abnormalities of the heart rhythm called arrhythmias can disrupt this normal cardiac control making it necessary to use some artificial means to regulate the rhythm of the heart Today some half a million men and women most of them over the age of sixty carry implanted cardiac pacemakers that take over the duties of the natural conduction system Tens of thousands of these devices are implanted each year in this country alone Over the past thirty years cardiac pacemakers have evolved from simple devices only capable of fixed-rate stimulation of a single chamber of the heart to more sophisticated implanted computers that medical personnel can interrogate and reprogram from outside the patients body These refinements have allowed for more physiologic pacing with maintenance of atrioventricular synchrony and cardiac output There are various types of cardiac pacemakers available today that can be surgically implanted to treat specific arrhythmic disorders in the heart Abnormal rhythms in the heart are one of the most frequent causes of heart malfunction and in most cases necessitate some type of cardiac pacing unit Cardiac arrhythmias are common in the elderly in who age-related physiologic changes often alter the conduction system of the heart Such changes may remain asymptomatic or they may progress to syncope or possibly sudden death In the event of acute myocardial infarction arrhythmias are no more frequent in the elderly than in younger
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