Basic Information Relating To Pacemaker Placement

By Laura Fox


The normal heart generates its own rhythm through specialized tissues found at the sinoatrial (SA) node. Electrical impulses from this region are transmitted to the rest of the heart resulting in contraction and relaxation and hence the filling and emptying of this organ with blood. In some cases, the heart is unable to undergo this cycle effectively creating the need for an artificial device or pacemaker.

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 will be made by the cardiologist. You will first be evaluated through a physical examination and investigations such as the echocardiogram and electrocardiogram. Once you have been identified as a suitable candidate, you will be prepared for the procedure. Part of the preparation includes shaving and the stoppage of any drugs and foods that may increase the risk of bleeding.

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.

The surgery is typically performed as a day case in most places. However, one may be admitted to allow for monitoring of the device overnight. If the rate is too high or too low adjustments in frequency may have to be made. Complications may also be identified at this time. They include, for example, bleeding, infections, abnormal rhythms and injuries to the lungs and heart.

Patients should have regular medical checkups. This are meant to help determine if the device is in proper working condition. The first full checkup should be done six weeks after the surgery. Unless complications have been encountered, subsequent checkups are then done after every six months. During the evaluation, a number of parameters have to be assessed. They include the threshold, the lead integrity and pacer sensing ability.

It is not an absolute necessity for one to change their lifestyle after surgery. However, one should take precautions to avoid damaging the device. For example, strong magnetic fields such as those in MRI machines should be avoided. There is also a need to minimize participation in contact sports that may damage the pacer. When undergoing invasive medical procedures, antibiotics should be administered as prophylaxis against infections.

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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