Information On Pacemaker Placement Patients Should Know

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By Laura Fox


The normal heart is controlled by electrical discharge originating from an area known as the sinoatrial node. The discharge flows from the atria to the ventricles and culminates in ventricular contraction. The contraction pumps blood to the large arteries and the cycle starts all over again. In some cases, the node is not discharging normally resulting into abnormal rate and rhythm. An artificial pacemaker will be needed in such a case to restore normalcy.

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 placed is usually made by a cardiologist. This is done after they evaluate the patient by taking a clinical history, conducting a physical examination and requesting for a number of investigations such as the electrocardiogram and the echocardiogram. Once the criteria has been met and one has been considered a suitable candidate the procedure is scheduled. Drugs likely to cause bleeding are to be avoided for a couple of days.

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.

There is no need to change your lifestyle even after placement of the device. However, there are a number of precautions that should be undertaken. For instance, you should avoid taking part in full contact sports as well as any activities in which they are likely to come into contact with strong magnetic fields. There may be a need for antibiotics when some medical conditions are being conducted to prevent infection of the device.

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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