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Just over 3 million Americans live with a pacemaker – a device designed to maintain better heart health. With Terminator actor Arnold Schwarzenegger revealing that he recently underwent surgery to have a pacemaker installed, many questions have been raised about the device and its function in one’s life.  

Pacemaker: What Is It, and Why Did Arnold Schwarzenegger Need One?

A pacemaker is a small, battery-powered device that plays a crucial role in maintaining a regular heartbeat. The purpose of a pacemaker is to keep the heart beating at a normal rhythm, if it senses that it’s beating too slowly, the device sends electrical signals to correct the beat.

Arnold Schwarzenegger was born with a bicuspid aortic heart valve, which can make the heart work much harder than it should later in life. On his podcast, Arnold’s Pump Club, Schwarzenegger revealed that he underwent surgery at the Cleveland Clinic to get a pacemaker installed.

“Last Monday, I had surgery to become a little bit more of a machine: I got a pacemaker,” he explained. Arnold. Although sharing health issues goes against his upbringing in Austria, “where nobody ever talked about medical issues,” Schwarzenegger decided to be transparent with his audience.

Schwarzenegger added,

“I’ve gotten so many messages and emails from people who were born with a bicuspid aortic valve, like me, telling me that talking about my valve replacement surgeries has given them courage and hope to deal with their own.”

Who would need a Pacemaker?

Pacemakers treat heart failure, which happens when the heart can’t pump enough blood into the body. They’re also used to treating certain types of arrhythmias, or irregular heartbeats, but not everyone with an arrhythmia needs a pacemaker.

There are a few different causes of arrhythmia:
  • Use of beta-blockers, which are medications to lower your blood pressure that can slow the heartbeat
  • Heart attack
  • Heart transplant
  • Certain congenital heart defects (a condition you are born with)

A history of heart surgeries

Schwarzenegger was born with the most common congenital heart defect, called a bicuspid aortic valve. The condition affects about 2 percent of the population, and it’s when the aortic valve contains only two leaflets (also called flaps) instead of the normal three. The aortic valve controls the flow of blood from the left ventricle to the aorta, which is the main artery that delivers blood to the body.

For most people with a bicuspid aortic valve, the valves work fine for many years, and they may not even know they have the condition.

Over time, often when a person is middle-aged, these leaflets may be thicker and stiffer than normal, which may cause aortic stenosis, a condition where the valve won’t open as easily as it should when the heart squeezes. As a result, the left side of the heart has to work much harder than normal. Over time, this can damage the heart muscle and even lead to symptoms of heart failure.

It isn’t clear why people are born with the condition, but it typically runs in families. Schwarzenegger’s mother and grandmother also had bicuspid valves; his mom refused to have valve replacement surgery and died as a result.

On his podcast, Schwarzenegger explained that the pacemaker had been implanted on the advice of his doctors,

“It was time to go through with this because some scar tissue from my previous surgery had made my heartbeat irregular. It had been like that for a few years.”

Schwarzenegger first had his heart valves replaced in 1997, and then again 21 years later in 2018. The valves typically last from 12 to 15 years. There was a complication during the second surgery, so the actor had only one replaced and then had the other replaced in 2020.

Symptoms that indicate heart issues

Some symptoms could indicate heart issues and perhaps the need for a pacemaker. They include:

  • Chest pain
  • Unusually fast or slow heartbeat
  • Irregular heartbeat
  • Heart palpitations
  • Shortness of breath
  • Unexplained dizziness, lightheadedness, nausea, or fainting
  • Unexplained confusion
  • Swelling in your ankles, legs, and abdomen
  • Getting up to urinate several times a night

How is a Pacemaker implanted?

Most modern pacemakers are wireless and are placed using a thin tube called a catheter. An X-ray machine guides the catheter and wireless pacemaker through a vein in your thigh to your heart. This procedure typically takes less than 1 hour.

You’ll likely need to stay in the hospital overnight after your pacemaker has been placed. In some situations, you may be able to return home the same day. Before you go home, your doctor will ensure the pacemaker is programmed properly for your heart’s needs and may order a chest X-ray. Your doctor can reprogram the device as required at follow-up appointments.

You’ll probably feel some pain or discomfort after your procedure, so you may need to take over-the-counter medications to alleviate this. It’s also important to care for your incision after you return home, so be sure to listen to your doctor, as they will give you instructions on how to clean the wound and prevent infection.

You may be able to return to your daily activities in the days following the placement of your pacemaker. However, avoid any rigorous exercises or heavy lifting for about 4 to 6 weeks, especially lifting the arm on the side of the pacemaker overhead.

Since the electrical signals that a pacemaker sends are very small, it’s unlikely that you’ll feel them. If you do, your doctor or cardiologist can adjust the programming of your pacemaker to minimize this.

Pacemakers can improve quality of life

According to one study, following the implementation of pacemakers, patients experienced improved emotional well-being, physical functioning and social functioning.

After the procedure, patients will see their doctor for a couple of weeks, and then once a year after that. Pacemakers also send reports directly to the doctor every three months. If any arrhythmias are found, the pacemaker notifies the doctor right away.

There are risks involved with getting a pacemaker, including:
  • infection near the implant site
  • blood clots
  • damage to blood vessels or nerves

As such, individuals should talk to their doctor before the surgery takes place.

Listen to Arnold’s podcast episode where he discusses his pacemaker on iTunes and Spotify.


Image: Arnold Schwarzenegger/Instagram
Tamlyn Bingle

Tamlyn Bingle

With an ever growing interest and appetite for sustainability, Tamlyn Bingle is an ambitious writer, her objective is to always share knowledgeable and insightful information in the written space. Tamlyn also enjoys living a healthy and active lifestyle, appreciative of nature and all creatures great and small.


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