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Do I Need A Pacemaker?

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In my year of conventional cardiology, I installed 100s of pacemakers, helping those people with shortness of breath and lightheadedness. All of the people had low heart rates without an obvious cause.

In this article, you will learn:

  1. What is a pacemaker
  2. Signs you may need a pacemaker
  3. How long will a pacemaker last
  4. What is the procedure to implant a pacemaker
  5. Are there natural treatment strategies to avoid a pacemaker

What is a pacemaker?

A pacemaker is a small electronic medical device that plays a crucial role in managing various heart rhythm disorders and ensuring that the heart beats at a regular and appropriate rate. This vital medical device has significantly improved the quality of life for countless individuals by maintaining the heart’s electrical system.

A pacemaker primarily serves to correct irregular heart rhythms, or arrhythmias, by sending electrical signals to the heart muscles. The heart’s natural pacemaker, the sinoatrial (SA) node, generates electrical impulses that travel through the heart, causing it to contract rhythmically. However, abnormalities in the SA node or other parts of the heart’s electrical system can disrupt this process. A pacemaker steps in by providing electrical stimuli to the heart when necessary, ensuring it maintains a consistent and safe rhythm.

Signs you may need a pacemaker

The usual complaints of someone who needs a pacemaker includes shortness of breath, lightheadedness, or fainting. Then, an ECG is obtained that shows the slow heart rate. Sometimes the slow heart rate is found on a Holter monitor or Zio Patch. If there is no cause for the slow heart rate, you need a pacemaker.

Types of pacemakers

There are several types of pacemakers, each designed to address specific heart rhythm abnormalities. The two most common types are single-chamber and dual-chamber pacemakers. Single-chamber pacemakers have one lead (a wire that connects the device to the heart), either in the atrium (upper chamber) or ventricle (lower chamber), while dual-chamber pacemakers have leads in both chambers. The choice of pacemaker type depends on the patient’s specific condition and needs.

Pacemakers have evolved significantly since their introduction in the 1950s. Modern pacemakers are remarkably small, about the size of a pocket watch, and are implanted just beneath the skin, typically in the chest. They are powered by lithium batteries that can last anywhere from 5 to 15 years, depending on the device’s settings and usage. These batteries are designed to provide a consistent and reliable source of electrical stimulation.

What is the procedure to install a pacemaker?

The process of implanting a pacemaker is typically done in a hospital or specialized cardiac clinic. Local anesthesia is administered to numb the implantation site, which is usually the upper chest. The surgeon then makes a small incision, often just below the collarbone, to create a pocket for the pacemaker. The leads are threaded through a vein into the heart and attached to the appropriate chambers. Once the pacemaker is in place, the incision is closed, and the device is programmed to meet the patient’s specific needs.

After the implantation procedure, patients often experience an adjustment period as their body gets used to the new device. Regular check-ups with a cardiologist or electrophysiologist are necessary to monitor the pacemaker’s function and ensure that it is appropriately programmed for the patient’s condition. These follow-up appointments also allow for the assessment of battery life and lead integrity. When the pacemaker starts to run out of battery life, the device needs to be changed. The pacemaker can come out, but the leads are there permanently.

In addition to their life saving potential, pacemakers also collect and transmit valuable data to healthcare providers, enabling the continuous monitoring of a patient’s heart health. This remote monitoring reduces the need for frequent in-person visits and enables rapid intervention in case of device malfunctions or changes in the patient’s condition.

Natural Treatment Strategies to Avoid a Pacemaker

Some people need a pacemaker emergently, if a cause for the slow heart rate (like hypothyroid or electrolyte imbalance) cannot be found. But working with Natural Heart Doctor will assure that you are working hardest to find the cause of WHY this happened.

The WHY are violations of Eat Well, Live Well, Think Well. Then we test, don’t guess and use evidence-based supplements. Ideally, the less you use the pacemaker, the better. The natural electrical system of the heart is always best. If you can fix it, great.

Talk to us, if you are looking to avoid a pacemaker, OR even if you already have one. We are here to help.


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Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.


Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

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Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

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Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

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Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

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Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.