Pacemaker Implant Surgery India | Temporary Pacemaker Implant at India Surgery Tour

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What is a Heart Pacemaker?

A cardiac pacemaker is a small device that helps the heart beat more evenly. Natural Heart Pacemaker (SA Node) is a small mass of specialized cells in the top of the heart's right atrium (upper chamber). It initiates and generates the electrical impulses that cause your heart to beat. If something prevents the pacemaker cells from doing their job, the heart may not beat normally. The doctors may then put in a man-made pacemaker made up of electrodes (thin flexible wires) and a generator (battery).

Why is a Heart Pacemaker required?

A Heart Pacemaker is used to stabilize dangerously slow heart beats (bradycardia) (less than 60 beats per minute). Slow heart beats can result from metabolic abnormalities, blocked arteries to the heart's conduction system, Sick Sinus Syndrome or SA node dysfunction (commonly caused by congenital heart defects, illnesses, cardiotoxic drugs, the natural aging process, or scar tissue from a heart attack), heart block or cardiac surgery. Because of this, the heart is not able to meet the body's demands, resulting in symptoms such as dizziness, extreme fatigue, shortness of breath, or fainting spells. Whatever the cause of symptomatic bradycardia, a pacemaker can keep the heart beating at a rate that allows to continue living a normal life.

What are the different kinds of Heart Pacemakers?

Heart Pacemaker can be:

Permanent (internal) Heart Pacemaker - This kind of Heart Pacemaker is implanted in a small pocket under your skin and is meant to be left in there for the rest of your life.

Temporary (external) Heart Pacemaker - This is used for initial stabilization of the patient during a cardiac crisis.

Temporary Pacemaker

Temporary pacemaker insertion is necessary for short term treatment of a slow heart rate which is causing symptoms, such as dizziness or a drop in blood pressure. It is a small catheter with a pacing electrode on the tip which is inserted through a vessel in the groin or neck.

The pacing catheter is advanced into the heart and programmed to stimulate the heart to beat at a more regular rhythm. This is a temporary measure, and in some cases precedes a permanent pacemaker implant.

Demand Heart Pacemaker - This kind of Heart Pacemaker has an inbuilt sensing device which senses when the heart beat is too slow and turns the signal on. Once the heart beat is above a certain level, it automatically turns the signal off.

Single Chamber Heart Pacemaker - This kind of device has one lead to carry signals to and from one chamber of your heart, either the right atrium or, more commonly, the right ventricle.

Dual Chamber Heart Pacemaker - This kind of Heart Pacemaker has 2 leads and can monitor and deliver impulses to either or both of the heart chambers.

Adaptive-Rate Heart Pacemaker or Rate-responsive Heart Pacemaker - This kind of Heart Pacemaker automatically increases the pacing rate to meet the body's changing need.

Which type of pacemaker will be suitable for me?

The type of pacemaker depends upon your medical history, physical condition, the nature of your heart condition, and the level of activity you normally incorporate into your lifestyle. Your doctor's goal in treating your heart rhythm disturbance is to provide the best possible therapy for you.

How does the Heart Pacemaker work?

The pacemaker consists of four major components

Batteries - The Heart Pacemaker operates with 2 lithium batteries.

Sensing component - This component of Artificial Heart Pacemaker senses whether the heart is generating a normal heart beat or not. If the sensing component senses that the heart is not generating a natural heart beat, then the Heart Pacemaker takes over this function and will send an electrical impulse to initiate a heartbeat.

Pacing component - This component of Artificial Heart Pacemaker sends the electrical impulse to generate a normal heart beat.

Programming component - This component of Artificial Heart Pacemaker is a computerized monitoring device which can adjust the settings of the Heart Pacemaker.

If the Heart Pacemaker circuit detects that the heart is beating too slow, then it will send a tiny electrical impulse called the pacing signal. This impulse travels through the wires of the pacing lead until it reaches the metal electrode which is in direct contact with the heart. This electrode delivers the electrical impulse to the heart tissue to begin a heartbeat. The pacing pulses are timed so that the heart beats in a manner very similar to a natural heart rhythm.

How is the pacemaker implanted?

Pacemaker surgery is often done using a local anesthetic and the person returns home the same day. Occasionally, a patient might be admitted to the hospital for a day.

The surgical procedure includes these steps:

An incision is made for the pacemaker. (This may be on either side of the chest or in the abdomen.

The leads are inserted into a vein and guided to the heart.

The leads are connected to the pacemaker.

The pacemaker and leads are tested.

The incision is closed.

The pacemaker is programmed.

The entire procedure for Heart Pacemaker implantation may take about 2 hours. You will be instructed remain fasting for 10 - 12 hours before the surgery.

How long does it take to recover and what is the aftercare?

The patient is taken to the recovery room and is kept under observation for an hour or so to check any immediate complications, and is later discharged that day. The patient resumes most of the normal daily activities a few days after the Heart Pacemaker implantation procedure. The stitches will be removed after about two weeks and doctor will provide instructions about programming, adjustment and to watch for low battery and malfunction signals to ensure optimum functioning of the Heart Pacemaker.

What precautions are to be taken after the surgery?

Keep the incision dry Do not sleep on that side Avoid putting pressure on the Heart Pacemaker Do not to perform any strenuous activities like lifting or over-stretching of the near arm for the next ten days or so

What are the common suggestions when living with a pacemaker ?

Carry the implant card with you at all times.

Do not have a Magnetic Resonance Imaging (MRI) test, electric cauterization, dental procedures using electrical appliances.

Keep the cellular phone at least 6 inches away from the Heart Pacemaker.

Ensure that your physician adjusts and checks your Heart Pacemaker whenever a new medication is prescribed.

Check periodically to ensure that your Heart Pacemaker is functioning correctly and that the batteries have not worn out.

As Heart Pacemaker are made of metal, they may set the alarm off when passing through metal detectors at the airport.

Can I participate in regular activities?

After pacemaker implantation, gradually increase activities as you are able to tolerate and per your physician instructions. Follow physician instructions regarding raising the arm above your head (on the side where the pacemaker is) and on any other recommendations.

How often do I need to adjust my pacemaker ?

Pacemaker reprogramming may be needed from time to time. Your cardiologist will evaluate data from the pacemaker and make adjustments if necessary.

How often do I need to replace my pacemaker ?

A pacemaker generator (battery) must be replaced every five to seven years. The battery energy is evaluated during every check done in the physician's office.

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