Cardiac Pacemaker Implantation
A Pacemaker is a small lightweight electronic device placed inside your body that
provides an electrical stimulus when your heart own natural pacemaker fails to
function. The pacemaker keeps track of your heartbeat and generates electrical
signals to keep your heart beating at the right pace and keep it from beating too
slowly.
Indication for an Artificial Pacemaker
Your cardiologist may recommend an artificial pacemaker for you if tests confirmed the
heart does not coordinate signals to pump.
You may have
- Heart block (electrical signals from the atrio-ventricular node cannot move
along the normal conduction pathways to the lower chambers of the heart)
- Sinus bradycardia (electrical signals from the sino-atrial node may be too
slow)
- Sick Sinus Syndrome (electrical signals may alternate between too fast or too
slow or occasionally stops)
You may experience symptoms of light-headedness, giddiness, shortness of breath,
fatigue, confusion and even blackouts.
Preparation Before Pacemaker Implantation
You will need to be admitted to the hospital for the implantation. Your cardiologist or
surgeon will be able to choose the type of pacemaker that is best for you depending on
the type of blockage present.
A pacemaker with one lead is called a single chamber pacemaker. Depending on where the
problem is, the lead is either placed in the right atrium or the right ventricle of
your heart.
A pacemaker with dual chamber has two leads, one ends in the right atrium and one in
the right ventricle. Two leads will help the heart to beat more efficiently by
coordinating the signals between the chambers.
Routine lab tests will be done prior to the procedure. Your cardiologist or surgeon will
explain the risk and complication of the procedure and obtain a written consent from
you.
An intravenous line will be inserted and the nurse will attend to your shaving to
prepare you for the procedure.
You should not eat or drink 6 hours before the procedure unless otherwise instructed.
How is the implantation of a cardiac pacemaker done?
Cardiac pacemaker implantation is done in the cath. lab equipped with radiographic
equipment.
A local anaesthetic is given to numb the area where the pacemaker will be inserted.
To create a pocket for the pacemaker, an incision will be made in your skin below your
collarbone for endocardial (inside the heart) implantation or in the lower chest for
epicardial (outside the heart) implantation.
The lead is usually threaded into a vein and guided into the heart chambers using x-ray
monitors. Electrical measurements are taken to ensure the leads are positioned well
before connecting to the pacemaker and programmed to a heart rate that is right for you.
The whole procedure takes an hour to complete. You will be transfer to stay overnight
in ICU to ensure the pacemaker is working properly and to monitor your heart using
telemetry. A nurse will be taking your blood pressure, pulse rate and any signs of
bleeding regularly.
You are not allowed to lift your arm above your shoulder on the side where the pacemaker
is implanted. It is normal to have pain and some stiffness in the area around your
incision for about a week or so. ECG and chest x-ray may be taken upon request from
your cardiologist or surgeon. You may need to stay 1-2 days in the hospital before
discharge for further observation.
Special precautions living with a pacemaker:
- Always carry a pacemaker identification card
- Show the pacemaker identification card at the airport screening device
- Familiarize with the manufacturers instruction on pacemaker
- Avoid close contact with high or strong magnetic fields e.g. electrocautery
machine, radio transmitting tower, ultra magnetic chairs or beds, MRI scan
used in hospital, cellular phones.
- Safe to use are electrical appliances such as microwave, computer, hairdryer,
radio, TV, electric blankets and vacuum cleaners.
- Avoid contact sports.
- Inform your dentist or doctor when seeking dental or medical treatment.
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