What is a pacemaker? A pacemaker is a medical device used to help control abnormal heart rhythms. The pacemaker is a small device that is placed in the chest. It can also record a range of important health indicators, including heart activity.
What is Pacemaker surgery? Pacemaker surgery is an invasive procedure that involves the implantation of a pacemaker in the chest to regulate heart rate and rhythm. The procedure often takes place in an operating room and may take around 1–2 hours. Pacemakers are used to treat Arrhythmias (a condition of the heart where the rhythm of the heart is irregular or abnormal). Arrhythmias can obstruct the heart from properly supplying blood throughout the body. This can cause symptoms such as:
• Shortness of breath • A rapid heartbeat • Weakness • Chest pain A pacemaker is a rescue solution to arrhythmias and is therefore advised in such situations. Based on the condition, a pacemaker can either slow down, speed up or stabilize the heartbeat. Pacemakers can relieve problems related to arrhythmias like:
• Fatigue • Fainting • A comparatively healthy lifestyle Types of pacemaker The types are based on the condition of the patient and are as follows: Single chamber pacemaker: Usually carries electrical impulses to the right ventricle of the heart. It uses one lead in the upper or lower chamber of the heart. Dual-chamber pacemaker: It helps to control the timing of contractions between the two chambers of the heart. It uses one lead in the upper chamber and one lead in the lower chamber of the heart. Biventricular pacemaker: Also called cardiac resynchronization therapy, it is a pacemaker for people with heart failure with abnormal electrical systems. This type of pacemaker stimulates the lower chambers of the heart to make the heartbeat more efficient. It uses three leads placed in 1. Right atrium 2. Right ventricle 3. Left ventricle Specialized pacemakers: Leadless pacemaker Before Procedure Before the doctor assesses the need for pacemaker surgery, several tests are done to detect the reasons for an irregular heartbeat. These could include: • Electrocardiogram (ECG) • Echocardiogram • Stress test • Holter monitoring: Specially used in cases to diagnose rhythm disturbances that occur at unpredictable times. It is a portable version of the ECG and records information related to the electrical activities of the heart in normal day-to-day activities. The surgery could likely be performed under local anesthesia which is beneficial to anesthetize the area of surgery. Therefore, the patient is likely to be awake throughout the surgical procedure. An intravenous line is placed through which medication can be administered to provide relaxation.
The incision site is then prepared/ cleaned and then the surgical procedure is followed.
After Procedure and Recovery After the procedure, one is likely to stay overnight in the hospital. During this time, the pacemaker will be adjusted according to the pacing needs analyzed. A period of rest is necessary, but a person can resume back to their normal routine in a few days. Adjustments:
Living with a pacemaker will require some adjustments in day-to-day activities. These include: • It is important to remain physically active, but with this comes the understanding of when to stop the activity before getting too tired. • Avoid putting pressure on the pacemaker • Analysing the pacemaker’s lower and upper limits and ensuring that the heart rhythm stays within these limits. • Avoid being around devices that might interfere with the pacemakers. Example: Mobile phones, Microwave ovens • In case of pain at the site of the procedure or anywhere around it, consulting the doctor related to intake of Over-the-counter drugs for pain relief. Also, regular check-ups are advised in case any problem arises. Special precautions: An electrical interference has little or no effect on the functioning of the pacemaker. Still, it is advisable to take a few precautions: Cell phones: Cell phones now being an important aspect of our lives in the tech-savvy era, it is important to know about the precautions related to them. It is safe to talk on a cell phone, but the cell phone should be at least 6 inches (15 centimeters) from the pacemaker. It is advised not to keep the phone in the shirt pocket. Medical equipment: It is necessary to make sure that the doctors and dentists visited for future consultations know the presence of a pacemaker. This is because, certain medical procedures, such as MRI, CT scans, cancer radiation treatment, and many such medical procedures could interfere with the pacemaker. Other possible risks include: • Infection at the implantation site allergic reaction to the dye used during a surgical procedure • Collapsed lungs
• A reaction to anesthesia or medication
• Blood vessel damage/ nerve damage
The procedure to implant a pacemaker is not a complex surgery. It does not require open-heart surgery.
• If no complications arise, the patient can go home within 24 hours of the surgery.
• Generally, the procedure is done under local anesthesia. Therefore, the complications arising due to the administration of general anesthesia can be avoided.
• Most pacemakers can be monitored remotely. In times like COVID, this feature is extremely important as it does not require the patient to visit the doctor frequently.
• The pacemaker has the facility to transmit to and receive information from the doctor’s office regarding the rhythm of the heart and heart rate, the functioning of the pacemaker, and its remaining battery life. • With pacemaker surgery, the complications are negligent and the quality of life is high. • There are instances where the patient might be allergic to the anesthesia or the fluoroscopic dye used. This can lead to some complications.
Fortis Hospital Blk Super Speciality Hospital Sir Ganga Ram Hospital Manipal Hospital Kims — Krishna Institute Of Medical Sciences Max Super Speciality Hospital, Saket BGS Gleneagles Global Hospital Nanavati Super Speciality Hospital Apollo Hospital S L Raheja Fortis Hospital Apollo Hospitals, Greams Road Fortis Escorts And Heart Institute Saifee Hospital Jaslok Hospital Bombay Hospital & Medical Research Centre
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