When the heart beats irregularly and produces heartbeats that are too slow, then an electronic device called, the pacemaker is placed on the chest wall to make the beats regular. A cardiac pacemaker device is used to confirm that the heartbeats do not drop to a dangerously low rate. If the heart runs at a slower rate, then the electrical impulse is generated in the pacemaker and sent to the heart through the lead to make the heart beat normal. In some advanced types of pacemakers, specific heart diseases can be treated like when the heart is not pumping blood in sufficient amounts then these advanced pacemakers can be used to treat the condition. There are many precautions to follow after the pacemaker implant. For example, MRI is contraindicated in a person who has a pacemaker, or diathermy is restricted to a person who has a pacemaker. Although the cardiac pacemaker implant procedure is generally safe, it still carries some risks and complications that should be prevented or managed in time so that it cannot complicate the recovery phase. After a cardiac pacemaker implant, regular follow-up is necessary to confirm the proper functioning of the pacemaker. The doctor reviews the activity of the pacemaker and also can change the settings of the pacemaker if needed.
Some of the cardiac pacemakers that are used to implant are:
This type of pacemaker is used to fix the irregular beats of the heart. It uses a wire in either the top or bottom of the heart to send electrical signals. It is useful in making the heartbeat at a regular rate.
Dual-chamber Pacemaker uses wires in both the top and bottom of the heart to make sure the chambers of the heart work together properly. It helps to pump blood efficiently.
The Biventricular Pacemaker has wires in three spots that work like a team. It helps to coordinate the rhythm of the heart, especially in people with heart failure in which the pumping action of the heart is compromised.
Rate-Responsive pacemaker acts like a fitness tracker. This pacemaker speeds up or slows down the heart rate, like when we walk or rest, to keep it in a healthy range.
Adaptive-Rate Pacemaker is a clever pacemaker that knows when to speed up or slow down by learning from the rhythms of the heart and the activities of a person.
Instead of wires, the leadless pacemaker has a tiny pacemaker device that is placed inside the heart and sends electrical signals. It is helpful to fix irregular heartbeats.
An MRI-compatible pacemaker is a special pacemaker that is safe during a big-picture scan of magnetic resonance imaging (MRI). This is a powerful diagnostic tool that can allow doctors to see inside the body without harming the pacemaker.
S-ICD is an advanced type of pacemaker. This device helps to restart a dangerously fast heart. It is placed under the skin and is a very powerful protector against life-threatening heart rhythm problems.
Here is a general overview of the Cardiac Pacemaker Implantation procedure:
Anesthesia: The anesthesia is administered to reduce the effect of pain and discomfort during the surgery.
Incision: A small incision is made according to the skill of the surgeon. Mostly the incision is made on the chest wall just below the collarbone.
Vein Access: A venous is used to thread a thin, flexible tube (catheter) through the incision into a large vein.
Lead Placement: One or more leads are carefully guided through the vein into the heart. The leads are positioned in the appropriate heart chamber according to the type of pacemaker being implanted.
Lead Testing: Once the leads are in place, they are tested to ensure they are correctly positioned and can stimulate the rhythm of the heart or sense its activity.
Pocket Creation: A small pocket is created under the skin near the incision site. This pocket is made to place the pacemaker inside.
Pacemaker Implantation: The pacemaker generator, which contains the battery and electronic circuitry, is placed in the pocket and leads are attached to the pacemaker.
Closing Incision: The incision is closed with stitches or surgical adhesive, and a dressing is applied with some medications.
Recovery and Monitoring: After the procedure, the patient is monitored for a short period in a recovery area. Most patients can go home on the same day or the next day depending on the condition of the patient.
The cost of Cardiac Pacemaker implantation in India ranges from ₹ 1,70,000 to ₹ 3,30,000. The cost can vary according to the type of pacemaker being used in the surgical procedure. The cost can also vary according to the facilities of the hospital and the skill of the surgeon.
Cardiac Pacemaker implantation Cost in India | Min in INR | Max in INR |
Permanent Pacemaker Implant-Double chamber | ₹ 2,40,000 | ₹ 3,20,000 |
Biventricular Pacing | ₹ 2,20,000 | ₹ 2,90,000 |
Permanent Pacemaker Implant-Single chamber | ₹ 2,20,000 | ₹ 2,90,000 |
Here are some common indications for cardiac pacemaker implantation:
Risk factors of Cardiac Pacemaker Implant
Some of the risk factors associated with Cardiac Pacemaker implants are as follows:
Infection
Like other surgeries, there is a risk of infection at the site of pacemaker implantation or anywhere in the body.
Bleeding and Hematoma
There is a risk of bleeding during and after the procedure. Sometimes the blood accumulates at the surgical site and can cause severe complications.
Lead Displacement or Fracture
The leads that are connected to the pacemaker to the heart can displace or break, which may require additional surgery or replacement.
Pneumothorax
During implantation, there is a small risk of damage to the lung. Air enters the chest cavity and can cause severe complications.
Allergic Reaction
Some patients may have allergic reactions to the materials used in the pacemaker or the leads.
Fluid Accumulation
Fluid can accumulate around the pacemaker or leads that can cause discomfort and affect the device's function.
Blood Vessel Damage
Blood vessels may be damaged during lead insertion. It can further cause complications of bleeding or hematoma.
Device Malfunction
Pacemakers can have technical issues or malfunctions that may require additional procedures or replacement.
Nerve or Muscle Stimulation
Improper lead placement can result in nerve or muscle stimulation and can cause discomfort and abnormal activities.
Scar Tissue Formation
Scar tissue can form around the leads during the healing process. The scar formation can further affect the normal functioning of the heart.
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