Know About Pacemaker

What is a pacemaker? A pacemaker is a tiny battery-powered device that is surgically implanted in a patient's chest to control the heartbeats and prevent it from beating too slow.

Also known as a cardiac pacing device, a pacemaker generally has two parts - a pulse generator and the electrodes. The pulse generator is a small metallic part that contains the electrical circuitry which generates the pulses. The electrodes or leads are insulated wires, which are attached to the heart and serve as a passage for the pulses sent by the pulse generator. Whenever the pacemaker detects any abnormality in your heartbeat, it generates pulses that are sent to your heart. These pulses compel your heart to beat normally. Some new pacemakers also have a sensory device, that helps to trace a physical activity and increase your heart rate accordingly

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Who needs a pacemaker? A pacemaker is usually recommended to patients with a certain type of arrhythmia, i.e. Bradycardia, which is marked by an abnormally slow heartbeat which is quite likely to happen after a heart attack.

You might also require a pacemaker if you have an irregular heartbeat beat, with the aim of alleviating the risks of heart failure.

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When should you see a doctor? You should immediately see a doctor if you are experiencing the symptoms like syncope, angina and breathlessness. These could be signs of sudden cardiac arrest triggered by the arrhythmia.

Your doctor will carry out a detailed examination and recommend some tests which will help to determine whether you need a pacemaker or not.

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What are What causes arrhythmia? Arrhythmia could be a result of any of the following:

• CAD or coronary artery disease
• Hypertension, which is marked by high blood pressure
• Cardiomyopathy, which refers to abnormalities is in the heart muscle
• Valve disorders and abnormalities
• Blood electrolyte imbalance
• Damage caused by previous heart attack
• The side effect of a heart surgery

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What are the benefits of a pacemaker? • A pacemaker can significantly help to relieve the symptoms caused by bradycardia or a slow heartbeat.

• Some pacemakers even improve the quality of the patients live by allowing them to increase the level of their physical activity.
• Certain pacemakers can be monitored remotely, which means you do not need to frequently visit your doctor
• Pacemaker batteries last for a very long time, about 5 to 15 years
• Peacemakers can help to prolong the life of patients suffering from a terminal illness like cancer.

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What are the different types of a pacemaker? • A pacemaker is broadly classified into three types:

• Single chamber pacemaker - A single chamber pacemaker only has one lead that connects the pulse generator to the right ventricle of your heart.
• Dual-chamber pacemaker - A dual-chamber pacemaker consists of two leads, one of which connects the pulse generator to the right ventricle and the other one connects it to the right atrium.
• Bi-ventricular pacemaker - Commonly referred to as cardiac resynchronization therapy (CRT) device, a Bi-ventricular pacemaker has three leads, that connect the right atrium, the right ventricle and the left ventricle to the pulse generator. The device is recommended for patients experiencing severe arrhythmia due to advanced heart failure.

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How safe is pacemaker implantation? Peacemaker implantation is a generally safe procedure that comes with minimal risks of complications. You will, however, be required to follow some strict guidelines after the implantation for your safety.

Is pacemaker implantation painful? The procedure is performed under the influence of anaesthetics and sedatives, which means that you will not feel any pain or discomfort.

However, you are quite likely to experience pain and discomfort after you gain consciousness. This usually lasts for 2 to 3 days and can be effectively managed with the help of pain medication. Apart from this, you may also experience slight bruising at the surgical site. This will also heal by itself within a few days.

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How to prepare for pacemaker implantation? You will be required to undergo proper examination and a series of tests, before the procedure. These include electrocardiogram, Holter monitoring, echocardiogram and stress test.

Inform your doctor about any medications that you have been taking or are allergic to. Make sure that your doctor is well aware of your medical history including any bleeding disorder Refrain from eating or drinking anything starting from 8 to 12 hours prior to the surgery.

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How is the procedure done? • You will be required to lie down on a table and the drugs and fluids will be started intravenously

• Your vitals will be monitored carefully throughout the procedure
• The electrode pads will be attached to the back and front of your chest and sedatives will be given to help you relax
• A sheath is introduced into a blood vessel under the collar bone, by making a tiny incision. This sheath serves as a passage for the lead wires.
• The lead wires are carefully inserted and guided towards the heart, with the help of a catheter.
• The wires will be carefully fixed in the desired location with the help of detailed imaging guidance.
• The other ends of the wires are connected to the pulse generator, which is carefully implanted under the skin, near the collarbone.
• This is followed by the removal of the surgical equipment and sealing of the wound.

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What to expect after the procedure? • After the procedure, you will be shifted to the ICU, where you will be kept under keen observation till you gain consciousness

• You will then be shifted to your room.
• Medicines and fluid will be given intravenously, and you will be allowed to eat only after you gain complete consciousness
• It is quite normal to feel pain and soreness at the surgical site. This is managed with the help of medication.
• You will be briefed about the lifestyle changes that you need to take care of, before discharge.

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