One of the most common diseases associated with mortality is cardiovascular problems. Due to the lack of physical activity, urbanized lifestyle, unhealthy eating habits, lack of nutrition, and various other socio-economic conditions – cardiovascular problems have steeply risen. While there are multiple medical treatments available for heart problems, a pacemaker remains one of the most important advances in providing care for patients. A pacemaker is not merely a device that cures heart problems, but is also essential in retaining the patient’s peace of mind, ensuring them a quality of life and providing assurance of safety. Technically, a pacemaker is a device that continuously monitors the heartbeat to record any erratic movements and sends electrical impulses to the heart muscle to maintain a healthy heart rate. Your doctor may recommend a pacemaker in conditions such as arrhythmia, fainting spells and congestive heart failure. Depending on the severity of the heart problem, an appropriate pacemaker from the three types is recommended:
- Single chamber: Carries electrical impulses to the right ventricle
- Dual-chamber: Carries electrical impulses to the right ventricle and atrium
- Biventricular: Corrects abnormal electrical systems by stimulating lower chambers of the heart.
Purpose of a Pacemaker Implantation
The main purpose of a pacemaker is to control the irregular heartbeat. These can be temporarily implanted to treat a slow heartbeat post a heart attack, surgery or a drug overdose. In other cases, permanent transplantation of a pacemaker is made to correct a prolonged irregular heartbeat or to treat heart failure.
An implanted pacemaker mimics the natural action of the heart’s electrical system, and typically comprises of two parts:
Pulse Generator: A small metal container which hosts the battery and electrical circuitry which regulates the electrical pulse rate sent to the heart.
Leads (Electrodes): These are insulated wires which are placed in the chambers of the heart or in one particular chamber to deliver the electrical pulses to adjust the irregular heart rate.
Pacemakers only function when needed. In case, the heart starts beating slowly, the pacemaker sends electrical signals to the heart to correct the beat. Also, recent advancements in technology have offered sensory pacemakers which detect the body motion and breathing rate and send signals accordingly.
Risks of a Pacemaker Implantation
Risks of complications from a pacemaker implantation surgery are very rare, but can include:
- Infection at the site of pacemaker implantation
- Allergy or reaction to the dye or anaesthesia used during the procedure
- Swelling, bruising or extensive bleeding at the site
- Damage to the surrounding blood vessels and tissues
- Collapsed lungs
Preparation for a Pacemaker Implantation
Before deciding the need and type of pacemaker required, the doctor will conduct several tests to know the cause of irregularity in the heartbeat. These tests include:
- Electrocardiogram (ECG)
- Holter monitoring
- Stress test
The procedure of a Pacemaker Implantation
Before the commencement of the procedure, the doctor will place an intravenous line to provide medication to ease pain and help the patient relax. The patient will mostly be awake during the procedure and will be administered with local anaesthesia to numb the incision area.
Once the chest is sanitized and the patient is sedated, the surgeon inserts one or more flexible, insulated wires into a major vein located under or near the collarbone. Once placed, the wires are guided to the heart through X-ray images. On the end of the insulated wire is attached to the pulse generator that is implanted under the collarbone skin.
After the procedure, the patient is kept under observation for a day or more depending on the recovery and general health. The pacemaker is set to fit the pacing needs of the patient. Once the patient is stabilized, he/she is discharged but advised to be accompanied by a close friend or family to be driven home safely.
The pacemaker’s condition including the battery life, the heart rate and rhythm are monitored by the surgeon remotely. In many cases, heavy exercises or physical exertion will need to be avoided. Also, one has to not apply any pressure at the implantation site and in case of discomfort or pain, medical advice must be taken immediately.
On the other hand, the patient will be asked to take several precautions such as:
- Using the cellphone at least at a distance of 6 inches from the pacemaker
- Avoid unnecessary lingering near or leaning against a metal detector
- Inform all doctors and medical professionals about your pacemaker and ensure it is registered well before any surgery, test or medical treatment
- Keep at least a distance of 2 feet from power-generating equipment such as welding equipment, high-voltage transformers or motor-generator systems
Results of a Pacemaker Implantation
A pacemaker tends to positively improve the heart condition and rectify symptoms caused due to slow heartbeat such as fatigue, fainting, lightheadedness, etc. The pacemaker condition should be assessed every three to six months and the patient must inform the doctor about any troubling symptoms after the implantation such as puffy ankles, swollen legs, fainting, dizziness, unexplainable weight gain, etc.
Most pacemakers today last for 10-15 years, post which their battery needs to be replaced. The battery changing procedure is simple, fast and requires less recovery time as compared to the implantation one. Since most pacemakers today adjust the heartbeat according to the physical activity of the body, the overall quality of life is not hampered and the patient can resume an active lifestyle.