Pacemaker surgery: Who Needs it and How it is Performed


The pacemaker surgery is recommended by doctors and cardiologists for several reasons. The two most common reasons that a pacemaker surgery is performed are heart blocks and bradycardia. A heart block problem occurs in the electrical system of the heart. This ailment happens when there is slowing down or disruption of electrical signal moving through the heart. There are certain disorders of the muscles as well as the nerves that can also result in a person having a heart block, and this includes muscular dystrophy. On the other hand, bradycardia is a medical condition of the heart wherein beat rate is slower than the required normal heart beat.


Aside from the top two reasons of why a pacemaker surgery is performed, there are also some other conditions wherein your primary physician may recommend undergoing this medical process. Heart disease damages and aging can cause damage in the ability of a person’s sinus node function. When this happens, the sinus node may encounter problems setting the correct pacing for your heartbeat.

These damages result in a slower heart beat that is already considered as abnormal. Damages to the sinus node can also cause abnormally long pauses in between heartbeats. It may also result in a person’s heart to have alternating fast and slow heart beat rhythms. This type of condition is referred to as the sick sinus syndrome.

A pacemaker implant can also be performed on a patient who had already undergone a procedure to treat an arrhythmia condition which is called atrial fibrillation. The pacemaker surgery helps regulate the heart beat rhythm of the patient after having this procedure. There are also some people who need to take beta blockers. These medicines may result in a slower heart beat. If this condition occurs, the pacemaker surgery is recommended.

Another situation where the pacemaker procedure is recommended is when the patient has heart muscle problems that result in the electrical impulses to experience trouble passing through the heart. The pace maker surgery is used to provide resynchronization therapy to the cardiac muscle to resolve this problem. Patients who suffer from the long QT syndrome are at risk of experiencing dangerous arrhythmias. This is where the surgical procedure of a pacemaker implant is performed.


Before a primary physician will recommend a pacemaker surgery to his or her patient, he is required to consider the signs and symptoms of arrhythmia first. These indications include unexplained fainting, shortness of breath and dizziness. He or she is also required to check the patient’s heart disease history, heart test results, and the medicines that the patient is currently taking. There are certain tests that can be performed to detect if a patient is suffering from arrhythmias. Some of these tests include EKG (electrocardiogram), Holter and event monitors, Echocardiography, Electrophysiology studies and stress tests.


Pacemaker surgery

The pacemaker surgery is considered as a minor surgical procedure, however; a patient who is about to undergo this process would still need to stay overnight in the hospital for the doctors and their staff to monitor them carefully. This medical procedure is performed through the use of a local anesthetic. A patient is provided with a mild sedative that will keep him or her relaxed and calm, but would not make them fall asleep during the pacemaker procedure.

The pacemaker implant requires the surgeon to make an incision of two to three inches long that is right below the collarbone of the patient. The pacemaker uses one lead that is inserted into a vein near the incision and is slowly advanced towards the location of the heart. A fluoroscope device will guide the surgeon as he slowly advances the lead and this will provide him a detailed image of the vein’s interior. As soon as the lead enters the heart, it will be attached to the cardiac tissue so that the lead’s position may already be tested.

The test is performed by sending small electrical impulses to the lead which is used to evaluate the response of the heart to the signals. An appropriate position for the pacemaker device allows the signal’s full strength to reach the heart. When this happens, the signal will enable the heart to contract and beat, resulting in a normal heart beat rhythm. There are times that the lead will be reseated within the vein to achieve the best position for the full strength of the signal to reach the heart.

After placing and securing the lead within the heart of the patient, the lead’s generator is implanted below the skin. The generator is a small box that measures ½ inch in length and ½ inch in width. This device is connected to the lead and is inserted through a small pocket of incision under the skin. After placing the generator under the skin, the surgeon then completes the surgical process by suturing close the incision and hooking up the patient to a heart monitor for close observation. The complete process of the pacemaker surgery generally just takes an hour to two.


Once the pacemaker surgery is completed, patients are expected to feel mild pain, sometimes moderate pain, around the area of the incision. Most individuals can feel the pacemaker outline once the incision has healed. Some patients may have mild scarring to mild deformities on the skin near the location of the generator. Pacemaker batteries typically run between 5 to ten years, so patients are required to make a battery change once every few years to ensure that the generator will run smoothly and properly.

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