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Pacemaker Implantation – Common Medical Tourism Procedures

Pacemaker Implantation

Definition:

Pacemaker implantation is a surgical procedure performed to implant a pacemaker in the chest, to control the abnormal heart rates. A pacemaker is an electronic device that regulates cardiac arrhythmia via low energy electric pulses. Depending on the requirement temporary or permanent pacemakers are implanted.

The electronic device called an implantable cardioverter defibrillator (ICD) is similar to a pacemaker. However, in addition to low energy electrical pulses an ICD utilizes high-energy electrical pulses to treat certain serious arrhythmia

Why it needed?

The pacemaker implantation is advised in conditions that includes

  • Bradycardia –slow heart rate
  • Heart block as a result of aging, muscular dystrophy or damage to the heart from a heart attack
  • Atrial fibrillation
  • Arrhythmia caused by long QT syndrome disorder
  • Sick sinus syndrome –alternate slow and fast heart beats
  • Congenital heart disease
  • Heart transplantation

Symptoms of irregular heart beats include

  • Fatigue or fainting
  • Tiredness
  • Shortness of breath
  • Loss of consciousness

Facts and figures

  • The pacemakers are implanted to everyone, no restriction of age, sex or race
  • In United States more than 100,000 pacemakers are implanted every year, cases are more in elderly; about 85% of pacemakers are implanted in people above age 65.
  • The first description about a ‘permanent’ pacemaker using epicardial electrodes was in 1960.

Advantages

  • Pacemaker helps patients to resume a normal lifestyle and makes life more comfortable, as there is reduction is the symptoms of arrhythmia like fatigue and fainting.
  • Patients can live more active life after implantation.
  • The associated complications with pacemaker implantation surgery are rare.

Disadvantages

  • Certain medical procedures can harm the pacemakers including MRI, Lithotripsy etc
  • The pacemaker  wires dislodged or break after surgery due to poor placement or activity
  • The pacemaker may required to replace if it stops working properly

Risk and complications associated with pacemaker implantation surgery includes

  • Swelling, bleeding ,bruising or infection at the implanted site
  • Damage to nerve or blood vessel
  • Lung complications
  • Allergic reaction to medicine
  • Faulty pacemaker that does not function as intended after the surgery (very rare)

Preoperative preparation

  • Avoid dental treatment before  surgery or take antibiotics as per the surgeon’s advice
  • Complete physical examination
  • Blood and urinalysis
  • Diagnostic test like ECG,  Eco cardiograph, Electrophysiology study, Stress Test, X-rays
  • Consultation with surgeon or doctor a week ago, and have a list of medicine which is to be taken or needed to be stopped.
  • Inform the surgeon about habit of smoking and alcohol. Quit smoking
  • Notify the surgeon if cold ,fever or sore throat develops few days before surgery
  • Have an arrangements with family and/or friends to help during the post-operative rehabilitation
  • Prepare home as per the requirement for the recovery after the surgery
  • Do not eat or drink anything after midnight the night before surgery

Postoperative care

  • After the procedure patient may need to stay in the hospital for maximum 1-2 days, during that time the monitors are checked to make sure the pacemaker is working properly.
  • Mild pain, swelling and tenderness would be felt in the area where the pacemaker is placed

Dos, Don’ts and Precautions to be followed after the surgery

  • Keep the implanted area clean and dry
  • Avoid strenuous activity and heavy lifting for 4weeks
  • Don’t drive for about 2weeks
  • Avoid close or prolonged contact with electrical devices or devices that have strong magnetic fields e.g. metal detectors, house hold appliances like microwave ovens, electrical generators
  • Avoid full- contacts sports like foot ball
  • Check the pacemaker batteries regularly, one can monitor battery life through a special telephone monitoring service

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