Pacemaker Placement

pacemaker

Pacemaker placement is the insertion of a small, electronic device in the chest to control irregular heart rhythms. A pacemaker uses low-energy electrical pulses to make the heart beat at a normal rate.

What is it? 

A pacemaker placement is a procedure that inserts a small device into the chest. The device is called a pacemaker and is composed of a pulse generator, one or more leads, and an electrode on each lead. The procedure is intended to aid the heart electronically in beating at a reasonable rate. The purpose of the procedure is to prevent the heart from beating at a dangerously low rate. A pacemaker placement may be required in the event of heart beat and rhythm problems like Bradycardia (sinus node causing the heart to beat too slowly), Tachybrady syndrome (alternating fast and slow heartbeats), or Heart Block (electrical signal is delayed or blocked leaving the SA node).

What should I do to prepare?

Patients receiving a pacemaker implant may need to consult with their doctor about stopping certain medications before surgery. The patient should neither eat nor drink from midnight during the night before surgery until after the completion of the operation.

What happens during the process?

The procedure starts with the patient removing any jewelry or items that may cause interference. This task includes shaving of hair at the insertion site. The patient will then remove his or her clothing and change into an operation gown. The patient has an IV placed in his or her arm to receive medication and fluids as needed. The patient is then instructed to lie down on his or her back where he or she is connected to an electrocardiogram to monitor vitals. The IV includes a sedative to relax the patient, but the patient remains conscious during the procedure. The incision site is sterilized, and a local anesthetic is provided. An incision is made, and the sheath is inserted into a blood vessel, and a lead wire is advanced through the sheath and into the heart. The pacemaker generator will then be inserted through the incision after the lead wire is attached. Lastly, the incision is closed and bandaged.

What are the risks and potential complications? 

There are several possible risks of the procedure including bleeding from the incision or catheter site, damage to the vessel at a catheter insertion site, infection, or pneumothorax (accidental puncturing of the lungs or a collapsed lung).  Further complications can present in patients who are pregnant, allergic to latex, medications or have pain and difficulty when lying on an operation table for a long time.

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