Before implanting a pacemaker are made a few investigations to confirm the indication:
recording the heart rate for 24 hours (Holter ECG);
Electrophysiological study which consists in exploring ways of driving electricity to the heart using a probe that is placed in the heart.
One or two electric wires;
A pulse generator.
Electrical wires – are made of metal coils covered with an insulating material. It ends by an extremity – electrode – that is placed in cavities: atrium and right ventricle.
Pulse generator – is called the stimulator, pacemaker or simply “battery”. It consists of a battery and an electronic circuit. It is embedded in a titanium box, light (approx. 25g), thin (6-8mm) specially designed that when implanted under the skin to be unnoticed.
There are “unicameral” pacemakers with a single fixed electrode in the right ventricle (most commonly VVI) or bicameral, with electrodes fixed atrial and ventricular level (DDD).
It must be carried out under local anesthesia. The procedure is simple: the cardiologist performs a small incision in the skin under the shoulder to enter radiological under control electrodes to the heart. Subsequently the pacemaker is fitted under the skin.
The surgery takes about 45 minutes with the variations depending on the operator and the complexity of the procedure. Intervention is generally well tolerated. Pain after surgery is minimal; the patient can immediately raise and is hospitalized for a few days.
The patient should receive a notebook that will be noted:
characteristics of the pacemaker;
The date of the next control.
Supervising the pacemaker:
Initially is supervised the scarring of the place of implantation. Local redness associated with pain, fever, are signs of infection and the patient must come to the emergency center where the pacemaker was implanted.
The appearance of the muscles contractions around the pacemaker or increase in volume of the arm also requires a visit to hospital.
At 6 weeks after implantation is recommended to control the pacemaker.
IMPORTANT! The pacemaker is a form of security is not a handicap. Thanks to it, symptoms of a heart that works too slowly, disappear and life can return to normal (you can drive, travel, things which were forbidden before the pacemaker implantation).
Lifetime of a pacemaker depends on the type of pacemaker, the battery capacity. Pacemakers have generally a grant for four years but life can exceed 5-7 years.
The signs of a pacemaker wears out occurs gradually in months. Cardiologist can detect the first signs of weariness – that appear without any problems to arise in the operation – using a magnet or a computer that reads pacemaker activity.
Cardiological control is advisable to effectuate every 6 months.
If signs of weariness are not detected by the cardiologist the pacemaker slows down by 10% on average and no longer adjusts at effort. Thus the patient can feel the pacemaker’s activity changing months before battery exhaustion. The supervision should be reduced to 2-3 months when the battery is approaching exhaustion time.
Any fainting, severe dizziness, loss of consciousness, fatigue requires going to the hospital.
Changing the pacemaker is a simple procedure because it only requires the replacement of the battery. Rarely are required changing electrodes.
Everyday life with a pacemaker:
have to get used to 30 g more;
Should avoid an excessive effort with the arm where the pacemaker is. Tennis players, hunters should prevent the physician to implant the device opposite the arm used;
Avoid sleeping on the side of the pacemaker.
Electrical household equipment in good condition does not influence the pacemaker activity: TV, remote control, radio, vacuum cleaners, and kitchen robots. Instead induction plates can be a danger to the patient who has the pacemaker.
Alarm systems do not affect the pacemaker activity.
Mobile phones must be used at a distance of 15cm from the pacemaker. Although the risk of interference is minimal is preferred mobile phone to be worn on the side opposite of the pacemaker.
Weapons detectors are without risk to pacemaker wearer, but it should be noted that the pacemaker may trigger a false alarm, so it is preferable to present the book that you have a pacemaker.
In the medical field should be avoided (well-known contraindications from the medical staff) electric scalpel surgery, radiotherapy sessions, cardiac MRI (the pacemaker is a contraindication to perform this methods).