Pacemaker implantation

Pacemaker Implantation


This surgical procedure is carried out to implant pacemaker in the patient’s chest, to control abnormal heart rate. The pacemaker which is an electronic device, regulates cardiac arrhythmia with low energy electric pulses. Depending on requirement, permanent or temporary pacemakers are implanted.

An ICD or implantable cardioverter defibrillator is just like a pacemaker. The difference is that ICD utilizes high energy electric pulses to treat serious arrhythmia in addition to low energy electric pulses.

Why it is needed?

Pacemaker is prescribed for:

  •      Slow beating of the heart (heart rate) or Bradycardia
  •     Heart blockage due to age, muscular dystrophy and damage to heart due to heart attack
  •     Atrial fibrillation
  •      Arrhythmia due to long QT syndrome disorder
  •     Sick sinus syndrome – alternating fast and slow heart beats
  •      Congenital heart disease
  •     Heart transplantation

Symptoms

  •     Fainting or fatigue
  •     Shortness of breath
  •       Tiredness
  •      Losing consciousness

Facts and figures

  •     Pacemakers can be implanted in everyone without restriction of sex, age or race
  •    100,000 pacemakers are implanted in US, with 85% implanted in those above 65
  •     Pacemaker was first described in 1960, which had epicardial electrodes

Advantages

  •    Pacemaker helps people to resume their normal lifestyle and makes their life comfortable, as there is reduction in arrhythmia, such as fainting and fatigue
  •     Complications after implantation are rare

Disadvantages

  •     MRI, Lithotripsy etc can harm pacemakers
  •     Sometimes pacemaker wires can break or become dislodged due to activity or poor placement
  •      Pacemaker might require to be replaced if it stops functioning properly

Risk and complications

  •      Bleeding, swelling, bruising or infection at implanted site
  •      Damage to nerves or blood vessels
  •     Lung complications
  •      Allergic reaction to medicines
  •       Pacemaker might be defective and does not work as intended after surgery

Preoperative preparation

  •     Avoid antibiotics or dental procedure before the surgery
  •      Complete examination of the body
  •     Urine and blood analysis
  •     Diagnostics tests such as echocardiograph, electrophysiology study, X-Rays, Stress Test and ECG
  •     Learn from doctor a week before surgery which medicine are to be continued and which stopped
  •       Quit smoking and inform the doctor about smoking or alcohol habits
  •     Notify surgeon if patient develop fever, cold, sore throat some days before surgery
  •     Arrange for  care givers after surgery
  •     Prepare home as advised by doctor for recuperation
  •    Don’t eat/drink anything after midnight pre surgery

Postoperative care

  •      Patient has to stay in hospital for 1-2 days. Monitors will be checked to ensure smooth working of the pacemaker
  •     Swelling, mild pain and tenderness will be felt where pacemaker is implanted

   

Dos, Don’ts and Precautions

  •      Implanted area should be dry and clean
  •       No heavy lifting or strenuous activity for about 4 weeks
  •      No driving for 2 weeks
  •      Avoid prolonged contact with electrical devices which have strong magnetic fields such as microwave, electric generators, metal detectors etc
  •     No football or other full-contact sports
  •     Check pacemaker batteries on a regular basis. They can be monitored through a telephone monitoring service