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| SURGERIES OF THE HEART |
Pacemaker Insertion
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Pacemaker Insertion is the surgical insertion of an artificial pacemaker, which is a small, battery-operated device that helps maintain a normal heartbeat by sending electrical impulses to the heart.
REASONS FOR THE PROCEDURE
An artificial pacemaker is inserted when the body's natural pacemaker—the Sinoatrial (SA) node—becomes defective due to heart disease, and causes the heart to beat too fast, too slow, or irregularly. Artificial pacemakers may also be used for malfunctions in the Atrioventricular (AV) node—the part of the heart’s electrical system that conveys signals from the SA node to the ventricles. Pacemakers can also be used in the setting of cardiac surgery.
RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE
* Obesity
* History of smoking
* History of excess alcohol consumption
* Bleeding or blood-clotting irregularities
* Regular use of the following prescription medications: high blood pressure medicine, muscle relaxants, tranquilizers or sedatives, insulin, beta-adrenergic blockers, or cortisone.
* Regular use of mind-altering medications.
BEFORE THE PROCEDURE
The following test may be conducted prior to the procedure:
* Blood tests
* Urine tests
* Chest x-rays
* Electrocardiogram (ECG, EKG) --a test that records the heart's activity by measuring electrical currents through the heart muscle.
In the days just before the procedure:
* The night before, have a light meal and do not eat or drink anything, including water, after midnight
* Empty bladder before the procedure
PROCEDURE
The patient will lie flat on a hard table; and the heart rate, blood pressure, and breathing are monitored. A small incision is made beneath the collarbone. The pacemaker is inserted through this incision, and the wires are threaded through a vein under the collarbone to the heart. When the procedure is complete, the incision is closed with stitches, which are usually removed one week after surgery.
AFTER PROCEDURE
* Heart rate and blood pressure will be monitored
* Before hospital discharge, pacemaker will be programmed to fit the pacing needs of the patient.
TIME TAKEN FOR THE PROCEDURE
About 2 hours
POSSIBLE COMPLICATIONS
* Excessive bleeding
* Surgical-wound infection
* Pacemaker malfunction
* Rupture in the heart muscle (rare)
* Death.
POSTOPERATIVE CARE
* Bathe and shower as usual. The incision area can be kept clean by gently washing with unscented soap.
* Return to work and regular daily activities as soon as one feels ready; sexual activity may resume as soon as the patient may feel able.
* Resume driving about one week after returning home.
* Avoid vigorous exercise, especially involving the upper body, for 4-6 weeks after surgery.
* Certain devices that contain powerful magnets or electrical fields (such as certain medical equipment) may interfere with the pacemaker activity. However, most standard home appliances (such as microwave ovens, electric blankets, heating pads, etc.) should not significantly change the pacing rates.
* The patient will be scheduled for follow-up pacemaker checks that will assess the status of the battery and how well the pacemaker is maintaining the heartbeat.
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| Last Modified :
Monday, May 11, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
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