- Pacemaker Implantation
- Types of Pacemakers
- Risks of the procedure
- Pacemaker Implantation Procedure
- Frequently Asked Questions
What is a Pacemaker Implantation?
- A pacemaker is a tiny electronic device implanted in the chest (just below the collarbone) to assist moderate sluggish electrical abnormalities with the heart. It's inserted under your skin by the surgeon to control arrhythmias or irregular heartbeats. It’s also used for the treatment of fainting spells, congestive heart failure and hypertrophic cardiomyopathy.
- Pacemakers are used to treat two distinct forms of arrhythmias:
- Rapid pulse is known as tachycardia.
- Sluggish heartbeat is known as bradycardia.
- Some people need a biventricular pacemaker, also known as bivent pacemaker. If you have serious heart disease, you may need a bivent.
Types of Pacemakers
Single Chamber Pacemaker-
Dual Chamber Pacemaker-
What Does a Pacemaker do ?
- Pulse generator: A battery and the electrical circuitry that controls the rate of electrical pulses supplied to the heart are housed in this small metal container.
- Leads (electrodes): One to three flexible, insulated wires are implanted in one or more chambers of the heart, each delivering electrical pulses to regulate the heart rate. Some modern pacemakers do not require leads. Leadless pacemakers are devices that are inserted directly into the heart muscle.
Why does a Person need a Pacemaker?
- Shortness of breath
- Damage to vital organs
Risks of the procedure
- Bleeding from catheter insertion site
- Damage to the vessel at the insertion site
- Infection of the incision or catheter site
How to Prepare for Pacemaker Implantation?
Pacemaker Implantation Procedure
Before the Procedure
- If you are susceptible to or allergic to any drugs, iodine, silicone, tape, or anesthetic agents, tell your doctor.
- Prior to the treatment, you need to be on an empty stomach for a certain amount of time. Your doctor will advise you on how long you can be on an empty stomach.
- Drugs such as prescription and over-the-counter, as well as herbal or other supplements, should be reported to your doctor.
- If you have a history of bleeding problems or are taking some anticoagulant (blood-thinning) drugs, aspirin, or other blood-clotting medications, notify your doctor. You will need to avoid taking any of these drugs before the operation.
- Before the operation, your doctor can ask you for a blood test to see how long it takes your blood to clot.
- You may be given a sedative to help you relax before the operation. If you're given a sedative and there's a chance you'll be discharged. After the procedure, you will most likely spend at least one night in the hospital for observation and to ensure that the pacemaker is working properly.
During the Procedure
- You'll be asked to take off any jewellery or other items that can create hurdles during the procedure.
- Prior to the procedure, you will be asked to empty your bladder.
- Prior to the procedure, an intravenous (IV) line will be started in your hand or arm to administer medication and IV fluids if necessary.
- You'll be hooked up to an electrocardiogram (ECG or EKG) monitor, which tracks and monitors your heart's electrical activity during the procedure with thin, adhesive electrodes. During the operation, the vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be controlled.
- Before the treatment, you will be given a sedative drug via your IV to help you relax. You will, however, most likely remain awake throughout the operation.
- Antiseptic soap will be used to disinfect the pacemaker insertion site.
- This area will be covered with sterile towels and aboard.
- At the injection site, a local anaesthetic will be inserted into the skin.
- The surgeon will make a small incision at the injection site after the anaesthetic has taken effect.
- A sheath, also known as an introducer, is inserted into a blood vessel, usually under the collarbone. The pacer lead wire would be inserted into the blood vessel and advanced through the heart through the sheath, which is a plastic tube.
- It is important that you stay completely still during the procedure to ensure that the catheter does not move out of place and that the insertion site is not compromised.
- The ECG will be checked to ensure that the pacemaker is operating properly.
- Sutures, adhesive strips, or special glue can be used to seal the skin incision.
After the procedure
In the Hospital
- You can be taken to the recovery room for observation or returned to the hospital room after the operation. Your vital signs will be checked by a nurse.
- If you experience any chest pressure or tightness, or any other pain at the incision site, you can call your nurse right away.
- You can get out of bed with assistance after your bed rest period has ended. When you first get out of bed, the nurse will assist you and monitor your blood pressure while you are lying in bed. To prevent dizziness from bedrest time, walk slowly.
- It's possible that the injection site would be sore or painful. If you are facing severe pain then a painkiller will be given to you.
- While you are healing, your doctor will pay you a visit in your bed. The doctor will provide you with clear guidance and will answer any questions you might have.
- You will be taken to your hospital room or released home until your blood pressure, pulse, and breathing are steady and you are alert.
Within a few days, you should be able to resume your usual routine. If you need to take some time to return to your regular activities, your doctor will inform you. For a few weeks, you can stop lifting or pulling on something. Depending on your doctor's preferences, you might be advised to restrict the movement of the arm on the side where the pacemaker was inserted.
Precautions to take if you have a Pacemaker
- Electric blankets, heating pads, and microwave ovens can all be used without interfering with your pacemaker's operation.
- Strong electric or magnetic fields, such as those generated by industrial machinery, ham radios, high-intensity radio waves (found near large electrical generators, power plants, or radiofrequency transmission towers), and arc resistance welders, must be avoided.
- There are no studies that necessitate magnetic resonance imaging (MRI).
- More information about what types of equipment can interact with your pacemaker can be obtained from your doctor or nurse.
- Before going for any radiological procedures, you must inform your doctor about the pacemaker.
Frequently Asked Questions:
The implantation of a pacemaker in the chest is a minor surgery that might take 1 to 2 hours.
Fatigue, dizziness, lightheadedness, fainting, and an inability to exercise without being out of breath are all indicators that it is required.
Infection at the surgical site and/or reaction to the device material, inability to provide therapy when it is needed, or obtaining additional therapy when it is not needed are all risks associated with it.
Permanent pacemakers are used to treat chronic heart rhythm disorders. Whereas a temporary pacemaker is used when the person is hospitalized and the device is used for a duration of time.
You should not drive for three weeks. Do not engage in strenuous activities, such as golfing or mowing, for at least four weeks.
The patient may experience pain or discomfort for the first 48 hours after pacemaker surgery. There may be some soreness around the pacemaker's insertion site. This normally goes away with time.