Pacemaker

 

A Pacemaker is a device that is used for the treatment of abonormalities of the cardiac rhythm.

The first case of human cardiac pacing was performed by an Australian anesthesiologist, Marck C Lidwalell in 1929.

Components of pacemaker device:

1. Generator - source of energy for the pacemaker.
2. Pacemaker Leads - wires connecting the generator to the heart.


Types of pacemakers:

1. Single chamber: lead implanted into
only one cardiac chamber.
2. Double chamber: leads implanted
into both cardiac chambers.


Uses of pacemaker.

Pacemakers are implanted to treat abnormalities of the heart rhythm, such as bradycardia (very slow heart rate) - causing weakness, shortness of breath, andloss of consciousness etc.


How are pacemakers implanted?

Pacemakers are implanted in a conscious patient by using local anesthetic, and by making a small incision in the upper anterior chest. This is followed by advancing leads (Special wires) through veins with the help of X-Ray Machine and placing the battery(generator) under the tissue below the skin.


Risks associated with pacemaker implantation?

The majority of pacemakers (95%) are implanted without any complication. Possible complications in the patients include:

1. The lead or the wire may detach from the heart (1 in 25 people).
2. Bleeding into generator insertion site (1 in 30 people).
3. Infection of pacemaker insertion site ( 1 in 100 people).
4. Injury to the lung which may require tube insertion into the chest.
5. Rarely (1 in 1,000 people), puncture of the heart (causing Tamponade) may occur. Pacemaker may had to be removed and at times, it could even be fatal.


Precautions required by pacemaker patients

- The patient is advised to consult the physician if pain persists, or if any swelling or bleeding can be observed at the pacemaker insertion site.
- For two weeks after implantation, avoid driving and overuse of the arm on the side of the generator.
- Regular follow-up appointments. Appointments are also booked if any new symptoms appear.
- Depending on the use of the devices, the generator may have to be replaced after 5-10 years of implantation.
- Since some investigations like MRI and some surgical instruments may interfere with the function of pacemaker, the patient should consult the doctor or cardiologist before undergoing such investigations or procedures.
- Carry pacemaker identification card.
- Pass through security instruments or metal detectors at a faster pace and avoid standing near such instruments for long time.
- Avoid keeping activated phones on the same side of pacemaker generator and use the opposite ear when using the phone.

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