Lokman Hekim University Ankara Hospital
Pacemaker - what is it?
A pacemaker (EC, pacemaker) is a device for maintaining the heart rhythm at a normal pace. His functional responsibilities include monitoring the work of the heart. In case of violations in the heartbeat, the device sends an electrical discharge to stimulate muscle contractions.
To date, the pacemaker is the most effective tool in the fight against arrhythmia.As clinical studies have shown, over time, it becomes increasingly difficult to eliminate arrhythmias. Therefore, treatment should be started immediately. If the arrhythmia has become permanent, and drug therapy does not eliminate disruptions in the rhythm of the heart, doctors recommend the installation of a pacemaker. The device provides constant maintenance of the work of the heart. Devices of the newest generation are able to recognize paroxysms (severe attacks) and block them instantly, preventing them from disrupting the work of the heart.
Types of pacemakers
Pacemakers are classified depending on how many sections (chambers) of the heart they are able to stimulate - one, two or three.
Single-chamber devices are “classic” pacemakers that appeared earlier than others and have 1 electrode. They are installed in one chamber of the heart - the ventricle.
Two-chamber - have 2 electrodes that are implanted in the ventricle, atrium and support their synchronous operation. “Double” stimulation is more effective for the patient. If the patient has atrial fibrillation and flutter, dual-chamber pacemakers automatically switch to a safe mode of operation.
Three-chamber pacemakers are high-tech models with three electrodes that stimulate contractions of 3 heart chambers according to a certain sequence. Such devices are installed in patients with the most dangerous type of arrhythmia.
The electrodes of the devices are divided by fixation into active and passive types . In active fixation, the electrode is implanted inside the heart using a corkscrew attachment. Passively fixed electrodes are attached with special antennae.
Installing a pacemaker
The pacemaker is fixed in the region of the left collarbone under the pectoralis major muscle. Through a puncture in the subclavian vein, the doctor passes the electrodes to the chambers of the heart and fixes the device to the tissues.
Implantation of a pacemaker is carried out under X-ray control, and the duration of the operation depends on the type of pacemaker:
- single-chamber set in 30 minutes;
- two-chamber - for an hour;
- three-chamber installation will take at least 2 hours.
The operation includes several successive stages:
- The preparatory period is the introduction of local anesthesia into the skin and tissues adjacent to the puncture site.
- Insertion of electrodes. The surgeon makes an incision under the collarbone and inserts electrodes through the vein into the desired chamber of the heart.
- Installation of the pacemaker housing. The doctor implants the body under the collarbone subcutaneously or deepens it under the pectoral muscle.
- Attaching electrodes to the installed pacemaker.
- Programming of the device according to indications of the patient.
Life with a pacemaker
Patients who have been fitted with a pacemaker have certain limitations in physical activity and the use of electromagnetic devices. Before any diagnostic examination, the doctor should be warned about the presence of a pacemaker.
Restrictions for a patient with a pacemaker installed:
- you can not undergo magnetic resonance imaging (MRI);
- it is forbidden to work with high-voltage power lines and stay near transformer boxes and metal detectors for a long time;
- doctors do not allow patients with an implanted pacemaker to engage in traumatic sports;
- you can’t keep a mobile phone in the chest area (in pockets, bags), long phone conversations are also undesirable;
- the area where the pacemaker was implanted must not be exposed to direct sunlight;
- Do not take very cold showers.
After installation, doctors recommend walking and regular health checks.