PROCEDURES


Pacemaker implantation

Overview

A pacemaker is a device that controls how fast the heart works. It’s implanted under the skin within the chest. A pacemaker has the vital function of increasing your heartbeat when it slows down or reduces a rapid heartbeat. Also known as a cardiac pacing device, a pacemaker is hugely beneficial in reducing the intensity of a heartbeat and managing arrhythmia. Surgery is the only way of implanting a pacemaker.

There are a few surgical pacemaker options of which include:

  • A single chamber pacemaker
    that delivers electrical impulses to the heart’s right ventricle.
  • Double chamber pacemaker
    that efficiently delivers electrical activity from the heart’s right atrium to the right ventricle.
  • Cardiac resynchronisation (biventricular pacemaker)
    is carefully placed to regulate the function of the heart’s lower chambers, the right and left ventricle.

Why it’s performed

A pacemaker is inserted to control a person’s heart rhythms. Normally patients who suffer a heart attack are advised to get a pacemaker inserted, particularly as a result of developing an abnormally slow heartbeat, a condition also known as bradycardia.

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Preparation

Before we insert a pacemaker, Dr Abelson runs a few tests such as an electrocardiogram (ECG), Holter monitoring, echocardiogram and stress test to assess the heart's function, including its rhythm.

Before surgery, a sedative is injected into an intravenous line to help you relax. Local anaesthesia is typically used over the chest to help numb the area where the incisions will be made.

Procedure

A pacemaker is implanted in a sterile theatre environment mostly via a small incision below the left clavicle (right side also possible if suits patient more). It is performed using local anaesthetic only. Wires (leads) are manipulated into the heart chambers that require pacing, secured into position and then attached to the pacemaker generator. This is then buried under the skin, and soft tissue in a "pocket" before the wound is closed with sutures. The procedure generally takes less than one hour, and patients can be discharged either the same day or the following day.

Recovery

You remain in the hospital that same day. Afterwards, we programme the pacemaker according to your heart rhythm goals. Dr Abelson will advise you to halt excessive exercise for at least a month. You will be prescribed pain medication and instructed to avoid placing pressure on the chest.


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FAQ

1Is a pacemaker a permanent device?
Yes, a pacemaker is inserted underneath the collarbone permanently to correct irregular and slow heartbeat.
2Does a pacemaker correct a fast heartbeat?
Pacemakers are used to intensify a slow heartbeat and reduce a rapid heartbeat. In addition, a pacemaker ensures the ventricles are functioning optimally and contracting normally.
3Does implanting a pacemaker require open-heart surgery?

No, inserting a pacemaker does not require an open procedure. Usually, you can return home the same day of pacemaker surgery. Prior to surgery, you are given medication to help you sleep. Then, a local anaesthetic is used.

“FIRST, DO NO HARM.”