Pacemaker Implantation

A pacemaker is a device that operates with the help of battery and is used to maintain regular heartbeats. The implantation process involves fixing it beneath the skin over chest region. The process is often carried out under general anaesthesia. This is required in case where the natural cardiac pacemaker is no more functional. The factors accounting for this includes heart block, Arrhythmias, slow natural pacemaker (sinus node disease) and Heart failure etc.

The pacemaker is a tiny box made of metal weighs not more than 50 gram. A battery made of lithium is the power generator placed within the box. A computer circuit converts the potential energy into electrical impulses that stimulate the cardiac muscles to polarise and repolarise. Pacemakers are divided into three and are

Single-chamber pacemaker – used in conditions featuring irregular beats of atrium.

Dual-chamber pacemaker – used in conditions featuring irregular beats at times.

Bi-ventricular pacemaker (cardiac resynchronisation therapy or CRT pacemaker) – used in cases of advanced cardiac failure.

Pacemakers are capable of responding to demand. The programming enables this feature and it stays inactive if the heart is functioning normally. It is capable of adjusting the intensity at which the signals are sent in different situations. The feature is also termed as rate responsiveness. Pacemakers are even capable of examining and storing cardiac rhythm. This stored data is of great importance and helps the cardiac team to determine the level of functioning. It is also possible to reprogram the pacemaker by passing electromagnetic signals even after fitting it.

Diagnosis

The following tests can help to decide between the need for a pacemaker or not.

ECG (electrocardiogram) – An ECG can record the electrical activity by the heart. Several electrodes need to be connected to various parts and the result is graphically obtained on a paper.

Echocardiogram – this involves usage of sound waves to study the pumping mechanism of heart. A probe placed on the chest can reveal the result upon the screen.

Blood tests

A blood analysis reveals the presence of cardiac enzymes in the blood and is an indicator of cardiac distress.

To prevent infection and maintain asepsis, the following measures may be employed:

• An intravenous antibiotic administration may be carried out.
• The chest region may be shaved.
• An antiseptic soap may be used to clean the area.
• Sterile drapes may be used to wrap you all over.

The pacemaker will be usually inserted inside a specially designed room called cath lab. The vital signs of the person will be monitored throughout the procedure. The implantation can be carried out in two ways namely Epicardial implantation and Transvenous (endocardial) implantation.

Risks

The associated risks include severely compromised health status of the person, infection: As common with all surgical procedures, infection is likely to occur, loosening of pacing leads: Avoiding too much physical exertion can prevent this, air trapped in the chest (pneumothorax): This is possible to happen amid the procedure. Death: This occurs very rarely.