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Monday, August 29, 2016

Information On Pacemaker Placement Patients Should Know

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 procedure used to insert the pacer is fairly simple. Local or general anesthesia are usually used for the management of pain. Once the anesthesia has been administered, a small cut is made on an area on the shoulder to be used for the insertion. Once in place, leads are directed to the heart under the guidance of an instrument known as a fluoroscope. The entire surgery takes an average of thirty to ninety minutes.

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.

One needs to have regular medical checkups so as to determine whether the device is functioning properly. The frequency varies from one patient to another but the general recommendation is that the first full checkup should be scheduled at six weeks after the operation. Subsequent checkups are then scheduled at six months intervals except in cases where complications are anticipated. The main parameters to be evaluated include the sensing ability, the threshold and the lead integrity.

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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