Information On Pacemaker Placement Patients Should Know

By Laura Fox


The normal heart is controlled by electrical discharge originating from an area known as the sinoatrial node. The discharge flows from the atria to the ventricles and culminates in ventricular contraction. The contraction pumps blood to the large arteries and the cycle starts all over again. In some cases, the node is not discharging normally resulting into abnormal rate and rhythm. An artificial pacemaker will be needed in such a case to restore normalcy.

The primary role of these devices in Princeton, NJ is to normalize the heart rate and rhythm. There are a number of secondary benefits as well. Fainting episodes in persons with heart disease are often treated in this manner. Such episodes result when blood flow to the brain is interrupted. Other common indications include congestive heart failure (in cardiac re-synchronization therapy) and heart muscle disease (hypertrophic cardiomyopathy).

The decision to have the device placed is usually made by a cardiologist. This is done after they evaluate the patient by taking a clinical history, conducting a physical examination and requesting for a number of investigations such as the electrocardiogram and the echocardiogram. Once the criteria has been met and one has been considered a suitable candidate the procedure is scheduled. Drugs likely to cause bleeding are to be avoided for a couple of days.

The process through which the pacer is inserted is fairly straightforward. Local or general anesthesia are used to minimize the pain. Once the area of interest has been numbed, a small cut is made on an area near the shoulder. The leads are then maneuvered to the heart through the guidance of an instrument known as a fluoroscope. This operation takes an average of 30 to 90 minutes. Antibiotics are usually administered to prevent infections.

Although the operation is considered a day case in most centers, you may have to be admitted overnight. This provides an opportunity for the heart rate and rhythm to be monitored. The frequency may have to be adjusted if the rate is either too high or too low. There are a number of complications that may ensue after the operation. They include bleeding, abnormal heart rhythms, infections and more rarely, puncture of the lung or the heart.

You will need to undergo regular medical checkups to establish that indeed the device is working optimally. The frequency of the checkups will vary depending on the condition of the patient. In general, patients have to have the device checked every 6 months. When you go goes for the checkup, a number of parameters are tested. They include the sensing ability, lead integrity and the pacer threshold.

There is no need to change your lifestyle even after placement of the device. However, there are a number of precautions that should be undertaken. For instance, you should avoid taking part in full contact sports as well as any activities in which they are likely to come into contact with strong magnetic fields. There may be a need for antibiotics when some medical conditions are being conducted to prevent infection of the device.

Patients with the device need to carry around identification cards. The cards carry important information such as their primary symptom, the cause of their condition and the electrocardiogram tracing. Other important information include the pacer center, date of manufacture, the model and the lead type. The card makes it possible for treatment to be provided even if the patient visits a different facility.




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