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Permanent Pacemaker Implantation
What is it
Pacemaker is an artificial electronic device, which delivers electric
pulses in the heart. These pulses stimulate the heart muscle to contract,
which is required for the normal functioning of the heart.
Why is it done?
IImplantation of the permanent pacemaker is done in patients who
suffer from slowing of heart rate. This may be due to impairment of generation
of the normal current inside the heart, or its conduction thru the various
parts of heart. In both these situations, the patient has slow heart rate,
may suffer from weakness, dizziness, or fainting spells. Often these conditions
may be life threatening. The pacemaker monitors the heart beat and maintains
the heart rate and rhythm according to the programmed parameters inside
the pacemaker.
How is it done?
The pacemaker is implanted in a special sterile room called 'Electrophysiology
Laboratory' and under local anesthesia, the patient lies on the operating
table fully conscious, though under mild sedation. In almost all cases,
the pacemaker is implanted on the front of the chest under the clavicle
(collar bone) on left or right side. This is done thru a small incision
of about 3 cm. One or two pacing wires are placed inside the heart thru
a vein, and are connected to the pacemaker.
How to avail?
If anyone suffers from dizziness or fainting spells, he or she should
be brought urgently to the emergency room where monitoring of heart rhythm
can be done, and if necessary, temporary pacing can be done to stabilize
patient's condition. Subsequently a permanent pacemaker is implanted if
adequate indication exists. Patients with less serious symptoms can go
to outpatient department and consult a cardiologist.
When is it done?
This treatment is warranted when there is evidence of reduced blood supply
to the vital organs eg recurrent blackouts or TIA (Transient episodes
of numbness or vision loss)- in case of brain, uncontrolled hypertension
in case of kidney or pain in the or legs on walking in case of limbs.
Before ... Precautions &
prerequisites
An ECG, chest X-ray, and certain blood tests are done before the procedure
to rule out infection and to check blood-clotting parameters. The patient
is admitted to hospital before the procedure, and then taken to the laboratory
after preparation of the implantation area which includes cleaning and
shaving of the front of the chest.
After
After the procedure, patient is taken to the intensive care unit where
monitoring of rhythm is done for a few hours. Subsequently patient is
shifted to the ward room for 1 or 2 days. Dressing of the implant site
is done after 48 hours and few more times in the next one week. Patients
are normally discharged from hospital after 2-3 days of pacemaker implantation.
Tariff
The cost of the pacemaker depends on the appropriate pacemaker for the patient, and varies from Rs 50,000 to 1,45,000.
Procedure Fee :
Single Chamber Rs 30,000
Single Chamber Rs 35,000
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