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Pacemaker Implant Surgery in India

Pacemaker is a very small device which measures about size of a half dollar piece which is designed to place under skin near heart so as to regulate heartbeat. Pacemaker is normally implanted as part of a Cardiac Resynchronization Therapy. There are a variety of reasons as to why people may need pacemakers. Most common among them is one of a group of conditions known as arrhythmias where rhythm of the heart is abnormal. Normal aging of heart may also be a good cause to disrupt heart rate & make it beat much slower. Another common cause of disruption of heartbeat is heart attack which can eventually damage heart muscle as a result. Some medications are also found to affect heart rate. However, pacemaker can effectively fix this problem regardless of underlying causes of abnormal rate of heartbeats. Pacemaker device is most often implanted in chest through a minor surgical procedure. Patients may subsequently be required to take certain precautions in daily life after installation of the pacemaker.

Pacemaker Implant

Why Undergo Pacemaker Implant Surgery?

Normally implanted so as to control heartbeat, Pacemaker can be temporarily implanted in order to treat problem of slow heartbeat following heart surgery, attack or overdose of medications. Pacemaker can also be permanently implanted to correct slowing of heartbeat which is medically termed as Bradycardia or in special cases help treat heart failure. It would therefore be ideal to know how heart beats so as to understand working of a pacemaker.

Natural Heart Beats

Heart is a fist-sized muscular pump with four chambers; two to the left & two on the right side. Upper chambers are known as the left & right atria while the lower chambers are the left & right ventricles. Heart chambers must work in synchronized coordination so as to properly function. It must also beat at an appropriate rate which is normally 60 – 90 beats every minute in resting adults. In case heart beats too slow or too fast, it will lead to fatigue, confusion, fainting & shortness of breath; that create other signs & symptoms with not enough of blood flowing through the body. Electric system of the heart controls the pumping action of heart chambers. Normal heartbeat starts within the right atrium in the sinus node. These cluster of cells act as a natural pacemaker with a spark-like plug generating regular electrical impulses traveling through specialized muscle fibers. Whenever electrical impulses reach both the left & right atria they contract so as to squeeze blood into ventricles. Subsequently, after a split-second delay which allow ventricles to fill, impulses reach ventricles & make them contract so as to pump blood to rest of the body.

What Can Pacemaker Do?

This implanted electronic device mimics action of the natural human pacemaker. Artificial implanted pacemakers consist of 2 parts.

  • Pulse GeneratorIt is a small metal container housing electrical circuitry with a battery that regulate rate of electrical pulses that are sent to the heart.
  • Leads (Electrodes)Consist of 1 – 3 flexible & insulated wires which are each placed in a chamber, or chambers of the heart. These deliver electrical pulses so as to adjust the heart rate.

Pacemakers are designed to monitor heartbeat. In case heartbeat is slow, pacemaker will speed up heart rate by sending electrical signals to heart. Additionally, most pacemakers also have sensors which detect breathing rate or body motion & which will eventually signal pacemaker to increase heart rate during exercise so as to meet increased need of blood & oxygen to tissue & muscles.

Types of Pacemakers


  • Single-Chamber PacemakerThis type of pacemaker usually carries electrical impulses from pulse generator to right ventricle of heart.
  • Dual-Chamber PacemakerThis type of pacemaker will carry electrical impulses from pulse generator to both right atrium & right ventricle of heart. Impulses generated by the pacemaker will help control timing of contraction between these two chambers.
  • Biventricular PacemakerThis type of pacemaker is an ideal treatment option for people with heart failure where electrical systems of the heart have been damaged. Biventricular pacemaker is designed to stimulate both the lower right & left ventricles of the heart in order to make heart beat more efficiently. Biventricular pacemaker paces both ventricles so as to encourage all or most ventricular muscles pump together. This eventually allows heart effectively pump more blood. Since this pacemaker’s treatment resets ventricles’ pumping mechanism it is also often referred to as (CRT) Cardiac Resynchronization Therapy.

Preparing for Pacemaker Implant Surgery

Patients will have to undergo several tests to find out cause for irregular heartbeat in order to determine as a good candidate for pacemaker implant surgery. Some of these tests could include the following.

  • ElectrocardiogramSensor pads with attached wires called electrodes are placed on chest & sometimes on limbs so as to measure electrical impulses of the heart in this noninvasive test procedure. Beating pattern of heart can often offer clues to irregular types of heartbeat.
  • EchocardiogramThis is a noninvasive type of test procedure which uses harmless sound waves that allow doctors observe heart without making any incision. A small plastic instrument called transducer is placed upon the chest during this procedure which collects echoes or reflected sound waves from heart so as to transmit them into a machine which uses sound wave patterns to compose images of a beating heart onto a monitor. These images are capable of showing how well the heart is functioning while allowing doctors to measure size & thickness of heart muscle through recorded pictures.
  • Holter MonitoringThis procedure is also known as Ambulatory Electrocardiogram Monitor. Holter Monitor ideally records heart rhythms for a complete 24 hours period. Wires from electrode on chest are taken to a battery operated recording device which is either carried in the pocket or worn on belt or shoulder strap. While wearing the monitor, patients will also maintain a diary jotting down activities & symptoms from time to time. Doctors will finally compare diary with electrical recordings in order to figure out cause of symptoms.
  • Stress TestQuite a few heart problems occur only during exercise. Electrocardiogram or echocardiogram is normally taken before & immediately after riding a stationary bike or walking on treadmill for a stress test. A variety of other types of treadmill exercise tests can also be done so as to evaluate heart. This can include an oxygen consumption test which will measure the amount of oxygen body has been using during exercise.

Pacemaker Implant Surgery Procedure

Surgery to implant pacemaker typically takes a few hours & is normally performed while patients are awake under influence of a sedative to relax. However, area where the pacemaker is to be inserted will be numbed. One or more than one flexible insulated wires or leads or electrodes will be inserted into a major vein near or under collarbone & which will be guided to the heart with help of X-ray images. While one end of each wire is secured to appropriate position in heart, the other end is attached to pulse generator which is normally implanted under skin beneath the collarbone.

Pacemaker Implant Surgery Aftercare

Patients will generally stay in hospital for one day following pacemaker implant surgery. Pacemaker is also programmed to specific pacing needs of patients before they leave. Return visit is also often scheduled so as to make any corrections required in pacemaker settings. Following this, pacemakers can most often be remotely checked using wireless technology through cell-phone or radiofrequency signals. Pacemakers are designed to receive & transmit information between the patient & the doctor through which doctors can access data like rhythm & heart rate & how pacemaker is functioning including amount of remaining battery life. These remote transmissions can be made at scheduled intervals or at unscheduled points of time whenever pacemaker sends an alert or when patients send a transmission in case they have any concern. This remote technology means to translate into fewer trips to the doctors; but patients will however still need to meet doctors in person for scheduled check-ups. Doctors most often recommend patients avoid heavy lifting or vigorous exercise for about a month following pacemaker implant surgery procedure. Patients may also have some pain & aches near the area where pacemaker is implanted. However, most of these pains are effectively relieved by over-the-counter medications like ibuprofen or acetaminophen, but would be a sensible idea to talk to the doctor before taking any pain relievers.

Special Precautions Following Pacemaker Implant Surgery


Precautions Following Pacemaker Implant Surgery

It is quite unlikely that electrical interference will stop proper working of the pacemaker machinery. Devices like electric drills, electric shavers, electric blankets, radios, toasters, remote controls, television & microwave ovens are generally safe & unlikely to interfere with functioning of pacemaker.

Sensible to Take the Following Precautions

  • Cell-PhonesAlthough it is safe to talk on a cell-phone, patients should avoid placing cell-phones directly over the site of pacemaker implantation while the phone is turned on. Nevertheless, it is still unlikely that pacemaker will misinterpret cell-phone signals as heartbeat & withhold pacing & thereby producing symptoms like sudden fatigue.
  • Security SystemsPassing through metal detectors at airports will not interfere with functioning of the pacemaker, though it may sound alarm due to the metal it contains. However, avoid leaning against or lingering near the metal detection system. In case security personnel insist on using hand-held metal detector device, ask them not to hold device near pacemaker any longer than it is necessary or tell them to use any alternative form of personal search. Carry an ID card stating that you are wearing a pacemaker so as to avoid potential problems.
  • Medical InterventionsPacemaker patients considering medical procedures involving intensive exposure to electromagnetic energy must tell the doctors about having this device. Such procedures generally include magnetic resonance imaging or MRI, shock wave lithotripsy using shock-waves to break up large kidney stones or gallstones & therapeutic radiation for cancer treatment. Electrocautery or surgical procedure to control bleeding can also interfere with functioning of pacemaker.
  • Power Generating EquipmentPacemaker patients should stand at least 60 cm or 2 ft away from high-voltage transformers, welding equipments or motor-generating equipments. In case they have to work around such equipment, doctors can arrange tests in workplace so as to determine if they interfere & affect functioning of the pacemaker.

Pacemaker Implant Surgery Complications

Complications resulting from pacemaker implant surgery are uncommon. Moreover, life-threatening complications resulting from pacemaker implantation procedure are rare. However, some complications in some cases may include the following.

  • Infection in the area where pacemaker is implanted.
  • Allergic reaction to anesthesia or dye used during pacemaker implant surgery procedure.
  • Bruising, swelling or bleeding at generator site; especially among patients taking blood thinning medications.
  • Damage to nerves or blood vessels located near pacemaker device.
  • Collapsed lung.
  • Puncture of heart muscle which can eventually lead to bleeding into pericardium lining of heart. This may also subsequently require emergency medical care.

Pacemaker Implant Surgery Outcome

Average battery life of pacemaker device lasts between 5 – 10 years. Entire pacemaker pulse generator is replaced when pacemaker batteries wear out. Another procedure is required so as to fix & replace pacemaker device. However, leads of pacemaker may either be left in place or eventually be needed to replace; procedure to change pacemaker battery is much quicker & requires much less recovery time than the first pacemaker implant surgery procedure. Pacemaker is the most suitable standard treatment for many conditions affecting the electric system of heart. Apart from preventing slow heart rates, pacemakers can effectively treat symptoms like fainting, lightheadedness & fatigue due to the fact that presently available pacemakers can automatically adjust heart rate to match level of physical activity & allow patients resume more active lifestyles.

End-of-Life Issues with Pacemaker

Pacemaker patients who have become terminally ill with conditions unrelated to heart like cancer, it is quite possible that pacemaker could prolong period of life. However, researchers & doctors have varied opinions upon turning off pacemakers during end-of-life situations. It would therefore be sensible for pacemaker patients to talk to doctors concerning turning off pacemaker device in such situations. It would also be ideal to talk to family members & other designated persons making medical decisions for pacemaker patients about what they should be doing in such end-of-life care situations.

Pacemaker Implant Surgery in India

Featuring some of the most renowned cardiologists in the world, India is one of the best medical tourism destinations in the world providing a wide spectrum of affordable healthcare solutions including cardiac procedures like Angioplasty in India, ASD closure, VSD closure, radio frequency ablation, Coronary Artery Bypass Surgery, aortic valve procedures, LVAD, Heart transplantation, mitral valve & pacemaker implant surgery for international patients. IndianMedTrip is a one-stop online-shop offering high-quality yet low cost surgical interventions for people willing to come to the subcontinent for effective treatments. Healthcare consultants associated with IndianMedTrip will also be glad to combine an exotic recuperation vacation at reasonable costs for foreign patients so as to make their pacemaker implant surgery a memorable experience.

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