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A pacemaker is implanted in the chest to regulate the heart rate and rhythm. A Pacemaker Implantation procedure is considered routine. Every day, hundreds of pacemaker implant surgeries are performed globally. The procedure often takes place in an operating room, cardiac cath or EP lab, and usually takes an hour or two.
Usually, pacemakers are implanted under local anesthesia and there will be minimal discomfort at the implant site. The part of your chest being operated is draped so you won’t see anything. It is normal to be anxious before any surgery. Also the cost of Pacemaker Implant Surgery in India is affordable due to wide availability of excellent cardiac experts and institutes. Check out the price of pacemaker surgery in India 2016 on our website.
Complications & Risks of Pacemaker Implantation in India
Almost all surgical procedure holds some possibility of complications. Typical risks with pacemaker implants in India are not life threatening, but may require a follow-up operation or a longer than normal hospital stay. Common complications are infection, bleeding, lead dislodgment. They occur in less than 1% of the cases.
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Methods for Pacemaker implant
- Endocardial Lead Positioning
The best pacemaker implant hospital in India use the most common technique that involves advancing the pacemaker lead, an insulated wire coil, into the heart through a vein. Once the lead is inside the heart, the physician places its tip to the inside lining of the heart. At this point, the doctor tests the lead to see if this location is suitable for pacing. s
The team tests the lead by attaching it to a small, hand-held computer called an analyzer. As the lead is checked, a technician or nurse calls out numbers. Another technician may monitor an electrocardiogram (ECG) machine and call out information to the doctor. Lead testing is not painful, but it is the loudest phase of the operation. These numbers refer to your pacing threshold (the lowest amount of energy needed to stimulate your heart to beat) and help the doctor determine the best position for the lead in your heart.
After the test, your doctor may decide to move the lead and run the test again. You may hear the team call out numbers several times as the doctor attempts to find the best position for the pacing lead. Repositioning and re-testing a pacing lead several times is not unusual in pacemaker surgery.
Once the leads are in place, you may be asked to take deep breaths and cough vigorously while the physician observes an x-ray of your heart. This is done to ensure proper and secure placement of the leads. Once the leads are in place, your physician plugs them into the pacemaker and slips the pacemaker into a small pocket made just beneath the skin of your upper chest. The pocket is closed with stitches to complete the procedure.
You may feel slight pressure while the leads and pulse generator are being inserted into the pocket; alert your physician to any signs of discomfort.
- Epicardial Lead Positioning
In another implantation procedure, an incision is made in the chest to expose the exterior surface of the heart. The lead is attached directly to your heart’s surface (epicardium). This method is usually performed under general anesthesia. The pulse generator is usually placed under the skin in the upper abdomen, but it may also be placed in the upper chest area. This method is usually used when there is some reason to avoid the endocardial positioning method.
After Pacemaker Implantation
After the surgery, you will be taken to a recovery room. You may feel slight soreness around the incision site where the pulse generator was implanted, which can be managed with medication. Depending on your particular case, you may stay in the hospital anywhere from several hours to several days
Though people are generally aware of their pacemakers for sometime after the implant, the sensation decreases eventually. Sometimes there will be a bruise at the area where the device was implanted. This is typical with any surgical procedure and will go away with time. If the incision becomes red, hot, more painful, swollen, or begins draining fluid, notify the doctor immediately.
The abnormal heart rhythm before the implant should diminish or disappear. Inform your physician about any new sensations after the pacemaker implantation to help him readjust the programmed settings of the device to suit your comfort level.
After the surgery, you may feel the urge to touch or poke the implant site which you should resist as the new pacemaker and lead can get tangled. During your follow-up visits, the doctor uses a computer called a programmer, to communicate with the pacemaker. Attached to the programmer is a small device called a wand. The doctor uses the programmer to adjust and fine-tune the pacemaker’s settings. The doctor places the wand over the implant site, and the programmer communicates with your pacemaker.
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- How long does a pacemaker last?
- Pacemakers can last anywhere between 5 to 10 years or more – on the average about seven years. Device longevity depends upon how hard the battery inside the pacemaker has to work, and is affected by how much energy is required to pace the heart and how the system is programmed.
- Are there different kinds of pacemakers for different activity levels?
- Today’s pacemakers imitate the wide range of lifestyles and activity levels of the people who use them. People enjoying tumulus activities can also get pacemakers to meet their individual needs.
- Can people hear and feel pacemakers tick inside of them?
- After a pacemaker is implanted, the patient will probably be aware of it for a while. This is a normal feeling and will lessen with time. It may seem a bit heavy at first, and it may feel uncomfortable when you lie in certain positions. Modern pacemakers are now so small that they’re almost completely hidden by the chest tissue and are barely noticeable.
- Do pacemakers affect the sexual life?
- A pacemaker typically doesn’t have any adverse effects on a person’s sex life. In fact, if it was limited before the pacemaker due to the excessively slow heart rate, it may be better after the surgery. However, you should avoid positions that place pressure on the arms and chest for the first four weeks of your recovery. Talk to your partner about any worries you may have, such as fear of opening up your scar, and work out ways to get around them. If you don’t feel like having full penetrative sex straight taway, there are many other ways to express your desire, so use your imagination. The risk of sex triggering a heart attack is low (around 1 in 1 million).
- Are there any diet restrictions?
- No, for overall heart health, physicians recommend a diet low in fat and sugar, and high in fiber.
- Can pacemakers set off airport security and interfere with aviation navigation equipment?
- Pacemakers do not prohibit patients from traveling, and also do not interfere with aviation navigation. Passing through the metal detector at airports will not damage a pacemaker, but the metal in it may sound the alarm. If this happens, show security personnel your ICD identification card.
- Will my pacemaker be affected by electrical equipment?
- Most home appliances like microwave ovens, blenders, toasters, electric knives, ultrasonic dental cleaners, televisions, VCRs, electric blankets, electric stoves, and garage door openers are good to go. Office and most medical equipment are also safe. Some specific advice is outlined below:
- Mobile phones – it’s safe to use a mobile phone, but keep it away from your pacemaker. Use the ear on the opposite side or a headset.
- Security devices – security at airports or anti-theft devices in shops can interfere with your pacemaker. They’re safe, as long as you go through them quickly and don’t linger. Inform security staff that you have a pacemaker fitted because it can set off the alarm.
- MRI scans – you must not have an MRI scan because it uses strong magnets. “MRI-safe” pacemakers do exist, but they’re not currently widely used. Other types of scan are safe.
- Lithotripsy – this is a treatment for kidney stones and must be avoided if you have a pacemaker fitted.
- If your job brings you into contact with strong electrical fields – such as arc-welding, diathermy or working with high-power radio or TV transmitters – or you have direct contact with car ignition systems, check with your cardiologist or pacemaker technician before returning to work.
- Avoid wearing magnetic bracelets and magnets near your chest.
- How will I be monitored?
- You’ll be attached to a special monitor so the medical team can keep an eye on your heart rhythm. The monitor consists of a small box connected by wires to your chest with sticky electrode patches. The box displays your heart rhythm on several monitors in the nursing unit. The nurses will be able to observe your heart rate and rhythm. A chest X-ray will be carried out to check your lungs, as well as the position of the pacemaker and leads.
- Will I be in pain after the procedure?
- You may feel some pain or discomfort during the first 48 hours after having a pacemaker fitted, and you’ll be given pain-relieving medication. There may also be some bruising where the pacemaker was inserted. This usually passes within a few days. Tell the staff if your symptoms are persistent or severe.
- When can I leave the hospital?
- It’s sometimes possible to go home on the same day you have the procedure, but you’ll usually need to stay in hospital for one or two days. You’ll need to arrange for someone to pick you up from the hospital and take you home. Before going home, you’ll be given a pacemaker registration card, which has the details of the make and model of your pacemaker. Always carry the card with you in case of an emergency.
- How soon can I drive?
- If you have an ordinary driving licence, you can start driving again after one week, as long as you:
- Don’t have any symptoms, such as dizziness or fainting, that would affect your driving
- Have regular check-ups in the pacemaker clinic
- Haven’t recently had a heart attack or heart surgery
- Tell the Driver & Vehicle Licensing Agency (DVLA) and your insurance company that you have a pacemaker.
- If you drive a large or passenger-carrying vehicle, you’ll have to wait six weeks after your pacemaker is fitted before driving again.
- How soon will I be back to normal?
- You should feel back to your usual self (or even better) very quickly. It’s best to avoid reaching up on the side of your operation for four to six weeks. For example, that means not hanging out washing or lifting anything from a high shelf. However, it’s important to keep your arm mobile by gently moving it to avoid getting a frozen shoulder. The physiotherapist can show you how to do this. You’ll usually be able to do all the things you want to do after around four weeks. The time you need off work will depend on your job – your cardiologist will usually be able to advise you about this. Typically, people who’ve had a pacemaker fitted are advised to take three to seven days off.
- When can I exercise or play sports again?
- You should avoid strenuous activities for around four to six weeks after having your pacemaker fitted. After this, you should be able to do most activities and sports. However, if you play contact sports, such as football or rugby, it’s important to avoid collisions. You may want to wear a protective pad. Avoid very energetic activities, such as squash.
- How can I care for my wound?
- Don’t get your wound wet until your stitches have been taken out. After that, avoid wearing anything that rubs against the area of your wound, such as braces. Women may need a new bra with wider straps. Avoid exposing your wound to sunlight in the first year because this can cause a darker scar.
- Will I have to have my stitches removed?
- It depends on the kind of stitches used. Many doctors use soluble stitches that dissolve on their own. Before you go home, you’ll be told what type of stitches you have. If you need to have your stitches removed, it will usually be after about seven to 10 days.
- What check-ups will I need?
- You’ll usually have your pacemaker checked after four to six weeks at the hospital where it was implanted. Provided this check is satisfactory, you’ll have your pacemaker checked every three to 12 months. If after having the pacemaker fitted and leaving hospital you feel you’re not getting as much benefit as you imagined, your pacemaker may need some small adjustments. The cardiologist or cardiac technician will be able to do this.
- What problems should I look out for?
- Signs that your pacemaker isn’t working as it should, or that you’ve developed an infection or blood clot, can include:
- Prolonged weakness
- A swollen arm on the side of the pacemaker
- Chest pains
- Prolonged hiccups
- A high temperature of 38°C (100.4°F) or above
- Pain, swelling and redness at the site of the pacemaker
If you experience any of these problems after having a pacemaker fitted, contact your GP or cardiologist as soon as possible for advice.
- Will I need to have another pacemaker?
- Most pacemaker batteries last for six to 10 years. After this, you may need to have the batteries changed. Ask your doctor how you’ll know when the battery needs to be replaced or recharged. Changing the batteries involves replacing the pacemaker box with a new unit. This is a simple procedure that may or may not require an overnight stay in hospital. The original lead or leads can usually be left in place, although occasionally they’ll also need to be replaced.
- How often will I need follow-up appointments?
- After having a Affordable Pacemaker Implantation Surgery in India fitted you’ll need follow-up appointments for the rest of your life. These may be every three to 12 months, depending on the type of pacemaker you have and how well it works. At your follow-up appointment, the technician or doctor will analyse the discharge rate of your pacemaker, measure the strength of the electrical impulse and record the effects of the impulse on your heart. Most modern pacemakers can store information about the state of the battery and the performance of the pulse generator. Your pacemaker can then be reprogrammed to the best settings for you, if necessary.
- Who should I tell about my pacemaker?
- You should tell your doctor, nurse and dentist about your pacemaker because you may need to avoid some medical tests and treatments, such as CT scans, MRI scans and TENS devices. You should also tell your family and close friends that you have a pacemaker fitted. Tell them what to do if you lose consciousness or collapse.
- Will the pacemaker improve my quality of life?
- Most people who have a pacemaker fitted feel that it has a tremendously positive impact on their life. Research shows that having a pacemaker can help you be more active. It may also help you stay out of the hospital and live longer. Above all, you should feel better, and previous symptoms, such as breathlessness or dizziness, should disappear.
- Why should a patient choose India Cardiac Surgery Consultants for cardiac care?
- India, Cardiac Surgery Site Network provides a vast number of high quality cardiac services. The cardiac team includes board-certified top 6 cardiologists and best cardiac surgeons, specially trained nurses, and registered technologists. The cardiac team at uses the most advanced technologies available to perform the Low Cost Pacemaker Implantation Surgery in India
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