The pacemaker, a tremendous medical invention, has saved many people live long, healthy lives. If you are wondering who received the first pacemaker, Arne Larsson received it in 1958. He lived a long life and died in 2001 at 86. Here, we will see when a pacemaker is needed, as well as the procedures and types of pacemaker surgeries.
What is a Pacemaker?
A pacemaker is a small device that stimulates the heart’s muscles to regulate its contractions. It is also called an artificial cardiac pacemaker. A conventional pacemaker has a pulse generator, leads, and electrodes. This device is implanted near the collarbone to artificially generate regular electrical impulses to the heart. It is essential for people with heart ailments.
When do you need a pacemaker?
When the heart beats too slowly or fast, this device helps regulate it by producing electrical signals and stimulating the heart. It sends electrical signals only when it senses that the heartbeat is not at the required pace, returning it to the standard rate. A pacemaker is generally used to treat a patient with arrhythmias. It is generally used in conditions like slow or irregular heartbeat, heart failure, or heart block. Doctors of Calwin Hospital in Nagercoil are experienced and have advanced medical equipment to provide reliable pacemaker surgery.
Procedures
Pacemaker surgery is a minor procedure performed under local or general anaesthesia. It involves fitting lead wires through the veins to the heart’s chambers and takes approximately one hour to fix the pacemaker. The method of surgery differs based on the type of pacemaker.
Before the Procedure
Ahead of the surgery, the healthcare professional will perform pre-operative assessments, such as blood testing, ECG (electrocardiogram), and chest X-rays. With this test, they will analyse your health and determine which type of pacemaker is suitable for you.
During the Procedure
After deciding on a particular pacemaker, the doctors cleanse the chest area and inject local anaesthesia into the area where the pacemaker will be inserted. This will help you relax and make the skin numb. During the surgery, you will be fully awake or half awake. They ensure you do not feel pain or discomfort during the process.
Transvenous Implantation
Transvenous implantation, or endocardial pacing, is the most widely used method. It has been used since the 1960s and was performed on people with permanent arrhythmia. In this procedure, the doctor makes an incision carefully beneath the collarbone, inserts lead (wires) through the vein, and tries to connect with the heart’s right atrium. These leads are delicate wires or insulated strings with electrodes. An X-ray image on a video screen will be used as a guide to place the lead at the right spot. Once this wire is placed, the lead is connected to the pulse generator on the other side. This pulse generator is planted in a pocket (a separate incision made near the skin of the chest or abdomen).
These leads sense the electrical signal from the heart and send electrical impulses from the pulse generator through the transvenous electrodes to it when needed.
Epicardial Implantation or the Surgical Method
Epicardial implantation is the most common procedure for infants and is also done in patients with single ventricle anatomies. It connects to the heart’s exterior rather than connecting the wires inside the heart’s chambers. The surgeon connects one end of the lead to the heart and the other end to the pocket, which is a separate incision made below the chest or armpits. This procedure takes more time than the transvenous procedure, around one to two hours, based on your health condition.
This procedure is performed for those with a heart infection or whose top and bottom chambers are not working correspondingly, a situation called heart block.
Wireless Pacemaker or Catheter-based Method
The wireless pacemaker is a one-piece device, holding a pulse generator and electrodes in a single box. It is an advanced procedure in which a catheter is injected into an artery near the groin or thigh area and threaded up to the heart. This procedure takes around one hour. It is usually performed in people with bradyarrhythmia or a slow heart rate.
Only a cardiologist can determine what pacemaker is best for you based on your health history, heart rhythm, and other tests.
After the procedure
After the procedure, the doctor checks heart rate and blood pressure to analyse pulse generation and sets them accordingly. Usually, you will be able to go back to your house a day or two days after the procedure. Strenuous activities like weight-lifting and intense physical activities for the first four weeks are not recommended. The pacemaker’s slight heaviness may initially be uncomfortable, but you will get used to it gradually. Take some precautions if there is a chance of standing near power-generating equipment like welding equipment, high-voltage transformers, or motor-generator systems. Also, be careful when near MRI, CT scans, radiation therapies, and security devices like metal detection systems. It is always better to carry the pacemaker ID card displaying personal and pacemaker details.
Possible side effects may include
Even though pacemaker surgery is considered safe, there are concerns regarding the side effects of the surgery. In rare cases, the below side effects can occur,
-> Blood vessels can get impaired during surgery.
-> Infection around the incision area, pacemaker wires or device.
-> Bleeding, swelling or bruising.
-> Formation of blood clots.
-> Lungs may collapse.
-> Moving or shifting of the device or the leads during inappropriate position.
-> Fluid or air can get trapped around the lungs.
Regular check-ups with the doctor are necessary to avoid certain situations. Talk to the doctor if there is any pain or uneasiness. Getting treatment from a trustworthy hospital like Calwin Hospitals in Nagercoil can help you be stress-free and in safe hands. The physicians will give extensive care and personal treatment to every patient.
Types of Pacemaker
A slow heartbeat can cause several d2iscomforts, such as severe tiredness, lightheadedness, and fainting. The pacemaker stimulates the heart and pumps blood more actively. There are three basic types of pacemakers.
a. Single-chamber pacemaker: This pacemaker holds a single lead, which will be attached to one of the heart chambers (either upper or lower). It usually focuses on facilitating the right atrium or right ventricle.
b. Dual-chamber pacemaker: This type of pacemaker has a couple of leads secured to both heart chambers (for the upper and lower). It focuses on the right atrium and right ventricle and is more expensive than a single-chamber pacemaker.
c. Biventricular pacemaker: This is also called the cardiac resynchronisation pacemaker. It has three leads secured to the right atrium and both ventricles. Patients with arrhythmias induced by heart failure will use this pacemaker.
Only a doctor can suggest the right pacemaker depending on the patient’s age, health history, viable atrial activity, and symptoms.
Conclusion
The pacemaker surgery procedure helps you to breathe normally by generating rhythmic electrical impulses. Pacemakers make the lives of heart failure patients normal again. Only experienced medical professionals can suggest and provide effective treatment for cardio-related issues. Calwin Hospitals is a multi-speciality hospital in Nagercoil, specialising in cardiology, pulmonary, and ophthalmology. Our doctors efficiently perform a successful pacemaker surgery procedure with a total recovery rate. If you or your loved ones need medical support, contact Calwin Hospitals‘ emergency team.