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Living with your pacemaker

When the heart's rhythm runs awry, breaking away from its natural beat, and its chambers strike up a discordant, chaotic note, unmindful of a fallen conductor (the natural pacemaker system), a storm knocks at the door. The heart's movements turn into a quiver-ineffectual and wandering, and life itself becomes suspect. At such times, an artificial pacemaker can infuse normalcy and set the house (heart) in order. No wonder then that since the late 1950s when pacemakers first came to be successfully implanted, over two millio11 people have bene­fited from them to lead almost normal lives.

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What is a pacemaker?
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Which diseased states of the heart require an implan­tation of a permanent cardiac pacemaker?

Which investigations are helpful in making the decision to implant a pacemaker?

Can a pacemaker be given to all kinds of patients?

How does a pacemaker work? What are its basic parts?

How is a pacemaker installed?

How long after the fixing of the pacemaker is the patient allowed back home?

Is this procedure risky?

Being an electrical device itself, does a pacemaker brook any interference from other electrical devices?

Are there any ways to check whether a pacemaker is functioning normally?

Are there any trouble signals to watch for?

What other precautions need to be exercised?

What is the normal life of a pacemaker?

 

What is a pacemaker?   Top  

A pacemaker, quite simply, is -an artificial, electrically charged device capable of restoring one of the most essential rhythms of life-the rhythm of heart. When the natural rhythm is affected as a result of a failure of sino-atrial node (where cardiac impulses are born), or a serious interruption in the pathway of natural cardiac impulse, the introduction of a pacemaker brings quick relief by turning the wayward rhythm back to normal. It enables the heart to beat regularly, with rhythm and precision.

This cardiac pacemaking, as it is otherwise called, can be of two kinds: temporary, with the help of an electrode pushed through a neck vein to the right ventricle and activating it through an external generator, purely as a temporary measure, to tide over an emergency situation and permanent, where an entire pacemaker system is fixed inside the body for regular, long-term use.

Which diseased states of the heart require an implan­tation of a permanent cardiac pacemaker?   Top  

Its most frequent use is in patients with Stokes-Adams attacks. Caused by complete heart block, a Stokes-Adams attack is liable to lead to bouts of convulsions and loss of consciousness in the patient from insufficient circulation of blood within the body.

The next frequent use of a pacemaker is in dysfunction of sino-atrial node, or the sick sinus syndrome, where the heart­beat becomes so slow as to lead to spells of fainting.

Its other less common indications include bundle branch blocks, congenital heart block, high grade atrio-ventricular block (following a heart attack), rapid heart rate arrhythmias, and sometimes, recurrent fainting spells of unknown origin.

Which investigations are helpful in making the decision to implant a pacemaker?   Top  

In most patients, the decision is made on the basis of a resting electrocardiogram. But in more complex cases, a 24-to­48-hour continuous ECG monitoring by the Holter procedure, or special kinds of cardiac electrophysiological studies may be necessary.

Can a pacemaker be given to all kinds of patients?

Generally, yes. But patients with accompanying extreme debility, dementia, advanced cancer, and very poor left ven­tricular function are not ideal candidates for a pacemaker.

How does a pacemaker work? What are its basic parts?   Top  

Today, many kinds of pacemakers are available. Each has a different function. As such, their mechanisms also vary. But generally, a pacemaker has three basic parts: (a) A con­tainer, called the pulse generator, which houses its battery and circuitry. The battery is the source of energy. The energy gets converted into tiny, electrical impulses inside the circuitry. Functioning like a mini-computer centre, the circuitry also controls the timing of electrical pulses required to be sent to the heart. (b) Insulated wires, which carry electrical pulses from the pulse generator to the heart. These wires are flexible enough to withstand the twisting and bending caused by body move­ment. (c) Metal electrodes, at the tip of the wire leads. They make contact with the heart. It is through them that the electrical impulses reach and stimulate the heart tissue, causing the heart to contract or beat. These electrodes also sense if the heart is beating normally, in which case the pacemaker withholds its electrical stimulus.

Most patients are given a pacemaker which stimulates 'the lower pumping chambers, the ventricles, of the heart. In some cases, however, it is more advantageous to fix a pacemaker which stimulates the upper (atrial) chambers. Both are called single-chamber pacemakers.

Another kind uses two leads and electrodes. One, an atrial lead which is fixed to the upper chamber; the other, a ventricu­lar one, which serves the lower chamber. Such pacemakers are called dual-chamber pacemakers.

Whatever its nature, the basic function of a pacemaker remains the same-maintaining regular rhythmic heart-beat, and preventing slow and irregular heart rates. This it does by sending out electrical pulses to excite a wave of contraction in cardiac muscles, as and when necessary; this means that it allows the heart to work on its own if the heart is beating normally and gets activated only when things go wrong. Thus, the pacemaker works on demand from heart. Almost all pace­makers in use today are of this type.

The single-chamber demand pacemaker can again be of two types: constant rate and rate responsive.

The constant type pacemaker paces the heart at only one rate (until the heart's natural rhythm takes over). This rate is set by the doctor at the time of its implantation.

The rate-responsive pacemaker, on the 0ther hand, detects the body's needs and or the activity level the user and varies its pacing rate accordingly, increasing or decreasing the heart rate as it does so. These pacemakers use sensors to detect changes occurring within the body.

If the user is engaged in physical activity such as walking, jogging, or gardening, the pacemaker rate automatically ad­justs itself to give a higher heart rate commensurate with the level of activity. When the user is at rest or sleep, the rate decreases according to the needs.

The developmen,t of these rate-responsive pacemakers has opened new vistas in the lives of patients, allowing them to perform all types of activities.

How is a pacemaker installed?   Top  

Implantation of a pacemaker is usually done by a small surgical procedure which takes less than 90 minutes and is performed under local anaesthesia. The majority of implants are performed as transvenous procedures. This means that the pacemaker lead is introduced through a vein. Usually, a vein in the upper chest region coursing below the collar bone is chosen for this purpose. The lead is threaded through the vein to a chamber within the heart under X-ray fluoroscopy eye. The tip of the lead (the electrode) rests directly against the inner heart wall.

Occasionally, however, the electrode has to be implanted on the outer surface of the heart. This need arises when a venous access is not available, or if the pacemaker is being implanted at the time of a heart operation. In such cases, an incision is made in the chest to expose the heart, and the electrode is attached directly to the heart muscle.

In either procedure, the pulse generator is placed under the skin in either the upper chest region or the lower abdomen, and the electrode lead connected to it.

How long after the fixing of the pacemaker is the patient allowed back home?

Usually, this is possible by about the seventh or the eighth day.

Is this procedure risky?   Top  

No. The operative mortality of pacemaker implantation procedure is less than 1 in 200.

Can a pacemaker user return to his normal lifestyle? Is walking, gardening, golfing, hunting, travelling, driving a car, taking a shower, swimming, resuming sexual activitity, and returning to one's job permissible?

Certainly, unless some other problem precludes it, or the doctor's advice 'is to the contrary. With rate-responsive pace­makers, patients have even been know!) to play racquets and tennis.

Being an electrical device itself, does a pacemaker brook any interference from other electrical devices?   Top  

No, a pacemaker has built-in features to protect it from interference by other electrical devices. The pacemaker user can therefore comfortably use common household and office electrical appliances. But these must be in good repair to avoid the possibility of an electric shock.

Are there any ways to check whether a pacemaker is functioning normally?   Top  

A good, simple way is to check one's pulse rate. Most pacemaker users are given suitable instructions as regards this by their doctor. 

Counting one's pulse is a very simple procedure. You just need to place two fingers of one hand on the opposite wrist. Do not press too hard. Press just enough to feel the steady beat under the skin. Count the-beat for one full minute.

It is a good idea to check one's pulse at the same time every day. For instance, it could be the first thing in the morning when you wake up and arise from bed. At other times too, when counting the pulse, make sure you are fully relaxed. A rest of five minutes or so before making the count should help.

Record the number of beats, the date, and the time of day in a special diary. If your pulse rate is above or below your normal pulse range (as told you by your doctor), rest for ten minutes and check it once again. If it is still not in the normal range, call your doctor.

Are there any trouble signals to watch for?   Top  

There are symptoms which suggest that a pacemaker may not be working properly. These are:

If these symptoms appear, call your doctor immediately. But such happenings are very unusual as the failure rate of modern pacemakers is extremely low.

Another symptom one should be wary of is any redness, swelling, or discharge developing at the site of surgical scars. If such symptoms appear, immediate medical consultation is required.

What other precautions need to be exercised?   Top  

It is a good practice to carry one's Pacemaker Identifica­tion Card on one's person at all times. It can be of great help in an emergency, and especially convenient at places such as airports, where security checks include metal detectors which may pick up the metal in the pulse generator.

Be regular in keeping your appointments with your doctor. Maintain your records properly.

Do not observe any laxity as regards the medication.

If you are ever advised to undergo medical resonance imaging (MRI) for diagnostic purposes, inform the radiologist about your pacemaker.

What is the normal life of a pacemaker?   Top  

The pacemaker battery in use today has a life of eight to ten years. As it cannot be replaced alone, being sealed inside the pulse generator, the entire unit needs to be replaced when the battery exhausts itself. If the doctor is satisfied with the previ­ously implanted lead, he can connect the same lead to the new pulse generator.

Herbal Cure for Heart - Complete Pack
Total Heart Support
Arjuna
Arjun Tea
Arjun Saar
Kumari Saar
Total Price
Divine Remedies Total Heart Support is herbal treatment for High Cholesterol, High Blood Pressure natural remedy, herbal solution for congestive heart failure, blocked coronary arteries, irregular heart beat, blocked circulation in extremeties, Natural Rejuvenation for Your Heart, Natural cleansing for circulatory system Arjun Tea is herbal, natural way to control cholesterol, blood pressure,coronary artery diseases

Free Shipping and Handling
Worldwide!
No Side Effects!
2 Bottles
1 Bottle
1 Pack
4 Bottles
4 Bottles
$47.90
$ 31.00
$ 14.95
$ 75.80
$ 75.80
$ 274.55
Price after Discount 20%
$ 220.00
Buy This Pack for Just $ 220.00
Free Shipping and Handling Worldwide! No Side Effects!

Click here to buy Individual herbal products for heart care, heart herbal cure, herbs for heart


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