Pacemaker Implantation Demystified: A Guide to Cardiac Arrhythmia Management
What is pacemaker implantation?
A pacemaker is an electrically charged medical appliance that controls arrhythmias. It is a device that helps keep the heart's rhythm. Pacemaker implantation can represent a life-changing heart treatment such as atrial fibrillation. Cardiac surgeons implanting a pacemaker into the chest require minor surgery. The pacemaker implantation procedure is generally safe, but there are risks, such as injury around the insertion. Novel pacemakers have two parts. Surgeons treat one part of the pacemaker as a pulse generator while the other sends electrical signals to your heart. Experts treat leads like small wires that run from the pulse generator to your heart. Cardiologists suggest a pacemaker due to arrhythmias, in which the rhythm is abnormal.
Pacemakers generally treat two types of arrhythmias:
- Tachycardia, a heartbeat too fast
- Bradycardia, a heartbeat too slow
Some patients need a different type of pacemaker called a biventricular or bivent. If you are a patient with severe heart failure, your surgeon may suggest a biventricular pacemaker. A bivent puts the two sides of the heartbeat in sync. This process is known as cardiac resynchronisation therapy (CRT).
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| The Journey of Pacemaker Implantation for Stability |
If your heart beats too quickly or slowly, your doctor may suggest a pacemaker. In either case, your body does not receive enough blood. Then it can cause:
- Excessive fatigue
- A feeling of fainting or lightheadedness
- If you have shortness of breath,
- Some damage to vital organs
- Death
A pacemaker balances your electrical system, which sets your heart rhythm. Cardiologists know that each heartbeat produces an electrical impulse that moves from the top of your heart to the bottom, signalling your heart muscles to contract. A pacemaker maintains a record of your heartbeats. Your cardiologist analyses this record to understand your arrhythmia. It is possible to accept that not all pacemakers are permanent. Patients can realise that temporary pacemakers can control specific types of problems. You may require a temporary pacemaker after a heart attack or cardiac surgery. You may also need one if a medication overdose temporarily decelerates your heart. Your cardiologist will diagnose you to see if you are a perfect candidate for a pacemaker.
How do I prepare for a pacemaker?
You will undergo several tests to confirm that a pacemaker is perfect for you.
- Your doctor will take your echocardiogram, which uses sound waves to measure the size and thickness of your heart muscle.
- Your doctor analyses your electrocardiogram. They may place sensors on your skin to measure your heart's electrical signals.
- Your doctor may ask you to wear a device that tracks your heart rhythm for a day.
- Your doctor conducts a stress test to monitor your heart rate while you exercise.
If a pacemaker is perfect for you, you need to plan for the surgery. Your surgeon will give you complete instructions on how to prepare.
- Your doctor may advise you not to drink or eat anything after midnight the night before your surgery.
- Your doctor may provide some instructions to follow.
- Your doctor prescribes specific medications for you to take before the test.
- Your doctor may ask you to take a shower and shampoo well. Bathing may reduce your chances of developing a potentially serious infection.
How does a cardiac surgeon perform pacemaker surgery?
The pacemaker implanting procedure may take one to two hours. Your doctor will administer a sedative to relax you and a local anaesthetic to numb the incision site. Your cardiac surgeon will make a minor cut near your shoulder. Your doctor inserts a small wire through the incision into a significant vein near your collarbone. Your surgeon will lead the wire through your vein to your heart. An X-ray machine will assist your surgeon in the procedure. Your cardiac surgeon will use a wire, and he may attach an electrode to your right ventricle. Experts found the left ventricle near the bottom of the heart chamber. The opposite end of the wire connects to a pulse generator. The implanted pulse generator has a battery and electrical circuits.
Your cardiac surgeon will install a generator under your skin, near your collarbone. If you are planning a biventricular pacemaker, your surgeon will attach a second lead to your right atrium and a third one to the left ventricle. The auricle is the upper chamber of the heart. Finally, your surgeon will use stitches to close your wound.
What happens after pacemaker surgery?
You can go back to your home that evening, or you could stay in the hospital overnight. Your doctor will confirm the pacemaker is precisely programmed for your heart's demands before you go home. During follow-up consultations, your doctor can reconfigure the device as needed. You can stay away from rigorous exercise and heavy lifting. You may also need to take OTC medications for any discomfort. You can clarify this with your doctor. You will use special equipment to connect your pacemaker to a phone line every few months. It sanctions your physician for receiving information from your pacemaker without the desideratum for an office visit. Although advanced pacemakers are less sensitive to electrical devices than older pacemakers, specific devices may interact with your pacemaker.
For example, you should avoid:
- You can avoid keeping a cell phone or Walkman player in your pocket over your pacemaker.
- You can stay away from using a smartwatch.
- You can only stand for a short time near certain appliances, such as microwaves.
- You can stay away from exposure to metal detectors.
The majority of issues associated with pacemaker implantation are transient.
What are the options for "Pacemaker"?
Options for a pacemaker include:
- Traditional pacemaker: This device is implanted under the skin, usually near the collarbone, and uses electrical pulses to regulate the heart's rhythm.
- Dual-chamber pacemaker: This type of pacemaker has leads implanted in both the atrium and ventricle of the heart, allowing for more precise control of the heart's electrical signals.
- Single-chamber pacemaker: This pacemaker has only one lead either in the atrium or ventricle, and experts use it when only one chamber of the heart needs pacing.
- Biventricular pacemaker (Cardiac Resynchronization Therapy, CRT): This device is used for individuals with heart failure and helps to coordinate the contractions of the heart's ventricles.
- Leadless pacemaker: This newer type of pacemaker is implanted directly into the heart without leads, reducing the risk of complications such as lead fractures or infections.
- MRI-compatible pacemakers: Pacemaker manufacturers design them to be safe for use with magnetic resonance imaging (MRI) machines, allowing patients to undergo MRI scans without concerns about interference with the device.
- Heart rate-responsive pacemaker: This type adjusts the heart rate according to the body's activity level, effectively mimicking the heart's response to physical exertion.
- Remote monitoring pacemakers: These helpful remote pacemakers are available with remote monitoring capabilities, enabling surgeons to monitor the device's function and the patient's heart rhythm remotely, eliminating the need for in-person appointments.
In conclusion, pacemaker implantation is vital for managing diverse cardiac arrhythmias and ensuring the heart functions optimally. The pacemaker, typically implanted in the chest area, administers electrical impulses to regulate the heart's rhythm and sustain proper cardiac function. While the procedure is generally safe and effective, it requires careful evaluation of the patient's medical history, thorough pre-operative assessment, and skilled surgical intervention. Post-implantation monitoring and follow-up care are essential to ensure the device's proper function and the patient's overall well-being. With technological advancements and ongoing research, pacemaker implantation continues to evolve, offering improved outcomes and quality of life for individuals with cardiac rhythm disorders.