Cardiac pacemaker: how is the operation going?

Author Ольга Кияница

2017-10-30

The process of pacemaker installation is not as complicated as it may seem. Today, this manipulation is equated to an operation to remove appendicitis. More questions arise in patients how to live, after the installation of ACS, but the process of surgical intervention itself is important.

The pacemaker (EKS) is an electronic device that is equipped with a special circuit and is capable of generating electrical impulses. For normal operation of the device there should be enough battery charge built into its small housing. Thin electrodes, which during operation are brought to one, two or three chambers of the heart, leave the ECS.

Every year, around 300,000 people are implanted around the world. pacemakers, which allows you to extend the life of patients with severe cardiac impairment.

Cardiac pacemakers are of various types. Most commonly installed single-chamber and two-chamber, with frequency adaptation and without it. Before the operation, the patient must be examined and the indications for implantation, which can be absolute and relative, are determined. Most often, the EKS is established with bradycardia, atrioventricular blockade, syndrome of weakness of the sinus node.

Video Implant pacemaker

Stages of pacemaker implantation

  1. Perform local anesthesia, the actions of which are enough to conduct a minimally invasive operation of 40-60 minutes duration. In rare cases general anesthesia is performed.
  2. A small incision is performed above the left or right chest muscle, through which electrodes are introduced into large vessels.
  3. With the help of an X-ray examination, the electrodes are placed at the same end in the heart cavity, and the other is attached to the device.
  4. The EKs are placed in a small niche, made over the chest muscle.
  5. Perform a small test of the implanted device.
  6. Seams are applied to the cut.

ustanovka-cardio stimulator

You can install EKS both on the right and on the left side. Also, depending on the indications, the localization of the device in the abdominal cavity can be selected. The final decision on the location of the device is taken by the attending physician.

The area of the thoracic muscle is the most immovable in the human body, therefore, when installing the EKS in this place, it is possible to avoid bending and breakage of the electrodes.

Re-implantation of the pacemaker is possible both in the former place, and in the new, more suitable. Pre-emptively remove the old device. Electrodes can install new ones, or connect the old ones. In the latter case, the total number of electrodes in the blood vessel should not exceed five.

Duration of pacemaker operation

The operation is increasingly shifting to the level of the minimally invasive procedure, resulting in a 40-60 minute non-observable time to conduct it. The less difficulty during implantation, the faster it passes. All the time the operation depends a lot on the type of pacemaker:

  • single chamber is set approximately 40-60 minutes;
  • two-chamber - about 1,5 hours;
  • three-chamber - up to 2.5 hours.

The greatest amount of time from the whole operation involves the treatment of antiseptic and suturing, but in large-scale clinics, even these manipulations take a minimum of time.

After surgery, the patient usually has several hours in the intensive care unit. If there are no seats in it, they can be placed in the closest room to it. In the absence of any complications, perform X-rays and electrocardiography. A patient with a normal course of the postoperative period, after approximately 2-3 hours, is sent to the general ward. In the future it is necessary to strictly adhere to the recommendations of the doctor, to timely pass the examinations, that will allow to extend the life of the device, and therefore - to significantly improve the quality of life of the patient.

What should a patient know about pacemaker implantation

There are several features that should be known to patients preparing for implantation of a pacemaker. In particular, during the operation, you need to lie firmly and, as a rule, look at the opposite side of the operating field. Some clinics offer pleasant music for greater comfort of the patient.

The operating field is often disconnected from the field of view of the patient. For this purpose, a special partition is used on which a towel is hung. Therefore, even turning his head or beveled eyes will not be able to see the course of the operation or the incision. Thus, most often you have to look at monitors or observe X-rays, which is used to promote the electrodes by vessels.

In the responsibility of a patient undergoing surgery for implantation of a pacemaker, it often comes to inform the doctor about uncomfortable feelings, often occurring at the cutoff. In most cases, burning, pressure is felt, and after the connection of the electrodes, there may be a feeling that the current runs through the veins. But this manifestation gradually passes through a few days.

It is important to remember that the overwhelming majority of patients note the absolute painlessness of a pacemaker implantation operation. In very rare cases, early complications may occur: bleeding, thromboembolism, infection with postoperative wound. Some patients have distal complications in the form of pacemaker tachycardia, ECS syndrome, premature disturbance of the pacemaker. But at the same time, many doctors assert that virtually unsuccessful operations are absent, therefore this procedure is considered as streaming.

Replacement pacemaker

Regular examinations with the cardiologist allow you to determine in a timely manner a decrease in the charge of the pacemaker. This often occurs when approaching the end of battery life, then during the next check the device generates a signal. Also, an indication for the replacement of the EKS is inflammation in the area of the implant and its breakdown.

To replace the device, perform an operation under local anesthesia. Electrodes can remain old, but it is better if there is a replacement for new ones. Today, bipolar, which is considered more durable and reliable, is increasingly used. With proper attention to the device on the part of the patient it is possible to lead a more qualitative way of life for 7-10 years.


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One response to “Cardiac pacemaker: how is the operation going?”

  1. Anonymous says:

    Спасибо ,нформативно и
    очень и как то спокойно стало…

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