Pacemaker Implantation Surgery: An Ultimate Guide for Patients

Pacemaker implantation surgery is a procedure used to implant a medical device called a pacemaker into the chest of a specific type of cardiac patients. These patients typically include individuals who suffer from arrhythmia, which is characterized by abnormal or irregular heart rate and rhythm.

For the same reason, this procedure is also known as heart pacemaker surgery. A pacemaker works by directly regulating the beating of the heart, and thus maintaining a normal heart rhythm and heart rate. This is achieved with the help of the two components that work in coordination with each other – the pulse generator and electrical leads.

A pulse generator contains a battery and the electronic system that helps control the heartbeat. It is attached to one or more leads that send electrical signals to the heart muscles and control their functioning. The leads, thus, connect the pulse generator to the cardiac muscles.

This article delves into the details of pacemaker implantation surgery, its types, procedure, risks, and cost. It also examines some of the common questions that patients typically have about heart pacemaker surgery.

Pacemaker Implantation Surgery: An Introduction

A heart pacemaker surgery is a common cardiac procedure performed at the best multi-specialty hospitals in India and abroad. It is estimated that more than a hundred pacemaker implantation surgeries are performed each day around the world.

A typical heart pacemaker surgery lasts for about one to two hours and is usually performed under the influence of local anaesthesia. The patient is operated upon by a cardiac surgeon in a normal operating room or a cardiac catheterization room.

The patients usually do not experience any kind of discomfort or pain during the pacemaker implantation surgery. Moreover, the cardiac surgeons take all measures to make sure that the patient remains unaffected during the surgery. The local anaesthesia administered to the patients makes sure that the patient does not feel any pain at the site of pacemaker implantation.

Best Candidates for Heart Pacemaker Surgery

Pacemaker implantation surgery is best suited for people who suffer from either one of the following two conditions:

• Tachycardia: Characterized by fast heart rate and rhythm.
• Bradycardia: Characterized by slow heart rate and rhythm.

Both these conditions may prove harmful to the life of the patient. In either of these conditions, the different organs of the patient’s body do not receive an adequate amount of oxygenated blood. This may lead to serious complications if the conditions persist for a long duration of time.

Light-headedness, shortness of breath, fainting, and excessive fatigue are some of the symptoms that indicate that the patient may be suffering from arrhythmia. However, only a cardiac specialist is able to diagnose arrhythmias with the help of specific tests.

Before pacemaker implantation surgery

Before pacemaker implantation surgery, a team of cardiology specialists first check whether you are fit enough to undergo the procedure. They will conduct a few blood tests and an X-ray to determine your overall health status, in addition to a verbal inquiry about your general health and other heart-related disorders.

Also, you will be asked about any of the heart diseases that has been running in your family or any other disorders you may be suffering from. In addition, you will be asked to start exercising regularly, change eating pattern, and stop smoking to improve your rate of recovery after heart pacemaker surgery.

During Pacemaker Implantation Surgery

The pacemaker implantation surgery is carried out by an experienced cardiac surgeon, typically those who hold a great experience in working with pacemakers and specialize in the treatment of arrhythmias.

Pacemaker implantation surgery in India is quite popular among medical tourists because the country houses some of the best cardiac surgeons in the world. In addition, pacemaker implantation cost in India is one of the lowest in the world. By opting for pacemaker implantation surgery in India, a medical tourist typically saves thousands of dollars that they would otherwise spend in their home country for the same quality of treatment.

Types of Pacemaker Surgery

The pacemaker implantation surgery is conducted in either of the following two ways:

Transvenous Pacemaker Implantation

This is the most common and preferred type of pacemaker surgery. In this procedure, the surgeon makes an incision on the left side of the chest (just below the collarbone) and inserts the leads into a vein that leads to the heart chamber.

The movement of the leads through the veins is monitored with the help of real-time X-ray. Once the leads reached the heart, it gets lodged into the cardiac muscles.

The other end of the leads is connected to the pacemaker, which is then placed inside a pocket created by the surgeon between the chest muscles and the upper skin of the chest.

This approach typically lasts for almost 60 minutes. It may take more time if the leads are required to be placed in more than one chamber or if the surgeon is conducting another heart surgery at the same time.

Epicardial Pacemaker Implantation

This is less common and less preferred approach for heart pacemaker surgery. In fact, it is an alternative way for placing a pacemaker.

During this procedure, the leads are attached to the outer surface of the heart by making a cut in the abdomen (just below the chest). The other ends of the leads are connected to the pacemaker, which is placed in a chest pocket as same as transvenous pacemaker implantation. This procedure is conducted under the influence of general anaesthesia.

Epicardial pacemaker implantation surgery is mostly conducted in the case of children and patients who are scheduled to undergo another heart surgery at the same time.

This procedure lasts anywhere between 60 and 120 minutes. It takes longer to recover after epicardial pacemaker implantation as compared to transvenous implantation.

After Pacemaker Implantation Surgery

Immediately after the heart pacemaker surgery, the patient is transferred to the recovery room where he or she can rest for a few hours or a day. Once their condition is stable, he or she is transferred to a hospital room.

Meanwhile, the cardiac surgeon keeps a tab on the recovery of the patient and his or her vital signs. If needed, tests are conducted to monitor the health of the patient and confirm the correct placement of the leads and the pacemaker device.

The patient may experience some soreness at the site of abdominal incision or cut made below the collar bone and chest. The pain, discomfort, and the soreness are managed with the help of medications for a few days until it gets reduced automatically.

Patients are advised to contact the doctor immediately if they experience any pain, swelling, redness, or fluid drainage around any incision site. Let the doctor know about any sensations that you feel after pacemaker implantation surgery, and the doctor will adjust the functioning of the pacemaker accordingly.

Precautions to take after undergoing pacemaker implantation surgery

• You may feel the need to poke or touch the site of pacemaker implantation but refrain from doing so.
• Keep mobiles phones away from the pacemaker device. Use the opposite side of the ear or use headsets if required.
• Make sure not to undergo lithotripsy, a laser procedure used for the treatment of stones, after getting a pacemaker.
• Make sure to inform the security staff in shopping malls, airports etc. that you have a pacemaker. The security and anti-theft devices may interfere with the functioning of the device.
• Do not undergo a magnetic resonance imaging (MRI) test ever after getting a pacemaker.
• Do not wear anything that has a magnet near the chest. Avoid wearing anything magnetic.
• Avoid jobs that directly expose you to electrical fields.

Common Myths and Facts about Pacemaker Implantation Surgery

Myth #1: Pain persists after pacemaker implantation surgery
Fact: Pain and discomfort last for just 24 to 48 hours after heart pacemaker surgery. After that, it should go away, if it doesn’t, tell your doctor immediately.

Myth #2: I will never be able to drive after pacemaker implantation surgery
Fact: You can drive normally as before after one week of the surgery. However, first make sure that you do not have any symptoms such as dizziness and fainting, go to the doctor for regular follow-ups, have a driving license, did not suffer from any recently-diagnosed heart-related ailment, drive a light vehicle.

Myth #3: I will not be able to play any sport after heart pacemaker surgery
Fact: You can play most sports after the surgery, except very energetic ones (example, squash). Most activities can be conducted without any problem. However, all of these activities must be avoided for a period of at least six weeks after the surgery.

Myth #4: My diet will be severely restricted after pacemaker implantation surgery
Fact: This is not true. There is no restriction on diet. The doctor may, however, ask you to lower your intake of salt and sugar to maintain heart health.

Myth #5: Pacemakers interfere with sexual activity
Fact: Pacemakers have no impact on your sex life, it can be as normal as before. However, make sure not to put excessive pressure on your chest.

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