Consequences and treatment after installing a pacemaker

According to medical statistics, in 3-5% of cases, after the installation of an EKS, negative consequences occur.

Despite the fact that the implantation of a pacemaker is performed under x-ray control, there is a risk of developing early operative complications:

• Internal bleeding.
• Infectious processes in the area of the wound.
• Damage to the tightness of the pleural cavity.
• Thromboembolism.
• Electrode offset.
• Violation of device isolation.

In some cases, late complications develop. Patients are faced with the so-called syndrome EX. There are frequent headaches and dizziness, possible loss of consciousness, shortness of breath and a sharp decrease in blood pressure. An implant can cause tachycardia. There is also a risk of damage to the device and its premature failure.

The appearance of any of the above symptoms is a reason for seeking immediate medical attention. The cardiologist examines the patient, prescribes methods for treating the pathological condition. In the future, the patient is put on a dispensary account with mandatory scheduled checks every 3-4 months.

Arrhythmia

Pathological disturbance of rhythm, frequency, and sequence of contraction / stimulation of the heart muscle is an arrhythmia. After installing an artificial pacemaker, it most often occurs due to the high sensitivity of the device.

To eliminate the unpleasant symptom should consult a cardiologist. The doctor will reprogram the device and tune its functions. Changing the parameters of stimulation will contribute to the restoration of physiological heart rhythm.

[1], [2], [3], [4], [5]

Heart pain after installing a pacemaker

The appearance of discomfort and pain in the chest after the implantation of EX-many patients mistakenly perceive for heart problems. In this case, to exclude serious pathologies, it is necessary to turn to a number of specialists: cardiologist, neurologist, psychotherapist.

Emergency medical care is needed if the pain in the heart after installing a pacemaker proceeds with the following symptoms:

• Frequent hiccups.
• Fainting and dizziness.
• The sensation of electrical discharges of the implant.
• A sharp drop in heart rate below the level set by the ECS.
• Swelling and inflammation of the tissues around the scar.
• Sound signals device.
• Heart palpitations and muscle twitching in the area of the apparatus.

Squeezing sensations in the chest (angina) are most often associated with such factors:

• Overwork and increased physical exertion.
• Change in muscle tone.
• Problems with ECS settings or electrodes.
• Neurological disorders.
• Osteochondrosis.

If the pain occurs a few months or years after the operation, then first of all it is necessary to exclude intercostal neuralgia of the thoracic spine. This pathology is characterized by severe pain and bouts of difficulty breathing with stabbing sensations when inhaling.

To eliminate the above reasons and establish the true factors of the disorder, you should contact your cardiologist. The doctor will diagnose the cardiovascular system and the spine, as some diseases of the back can be given to the chest area. Also subject to verification EX and its settings.

High pressure

The pressure after the installation of the EKS returns to normal, that is, its increase is not related to the implantable device and is of a physiological nature. In this case, complex pressure therapy with diuretics, calcium antagonists and other drugs is carried out to restore the pressure.

Artificial heart rate driver does not affect pressure. The main task of the device is the generation of impulses for normal contraction of the heart. At the same time, many patients who suffered from hypertensive crises prior to the operation note normalization of the disease state.

The standard of pressure in the presence of the EX-110-120 is 70-90. Indicators above or below the norm require diagnosis and, if necessary, treatment. For the correction of high blood pressure, patients are prescribed antihypertensive drugs. If necessary, prescribe antidepressants and sedatives.

Extrasystole with a pacemaker

One type of heart rhythm disorder with premature ventricular contractions is extrasystole. When implanted artificial pacemakers, it does not occur often. A painful condition is manifested by the following symptoms:

• Feeling heart failure.
• Increased weakness
• Respiratory failure.
• Dizziness.
• Angina pain.

To eliminate the signs of ventricular extrasystoles, it was recommended to change the EX-mode in the direction of increasing the frequency of stimulation. In other cases, patients are prescribed antiarrhythmic drugs, sedatives and ß-blockers. It is mandatory to diagnose using ECG and Holter monitoring.

[6], [7], [8], [9]

Hand pain

Some patients who have undergone surgery to install a medical device to maintain heart rate, note the appearance of pain in the arm. Discomfort is manifested by a feeling of aches, loss of sensation and slight swelling. In this case, unpleasant symptoms occur in the limb, near which a pacemaker is installed.

• The most common cause of pain are side effects and allergic reactions to drugs that are prescribed in the postoperative period.
• Discomfort can be associated with impaired blood circulation in the vessels of an extremity, osteochondrosis, arthritis, and scapulohumeral periarthritis.
• The hand may hurt due to prolonged immobilization. In medicine, such pains are called contractures. Unpleasant sensations occur in the first time after surgery, as well as if within 1-2 months to avoid any movements with the hand, where the EX is implanted. As the development of limb pain passes.
• The pain occurs when the implant is located close to the nerve endings, as well as with inflammation of the EX-bed.
• Another possible cause of pain is medical error. This may be vein damage with electrodes or infectious complications. In the first case thrombophlebitis develops, the limb is hyperemic and painful, it increases in size in relation to healthy.

In order to establish what caused the pain and eliminate it, you should contact your cardiologist or surgeon to undergo a set of diagnostic examinations.

Swelling of the feet

Heart failure is one of the common causes of lower extremity edema. Problems in the heart cause a violation of the output of fluid from the body, which leads to its accumulation in different parts of the body. The pathological condition is called anasarca and requires serious treatment.

The appearance of edema after insertion of an artificial heart rate driver is possible in the first months after surgery. As healthy stimulation recovers, excess fluid ceases to linger in the body and is excreted by physiological means.

If the edema is systematic, spreads to other parts of the body and lasts for a long period of time, this may indicate a pathology on the part of the kidneys. In this case, the patient is prescribed medical therapy, which will get rid of the swelling and prevent its development in the future.

Cough with pacemaker

Coughing attacks after installing EX can occur due to various reasons, consider the main ones:

• Side effect of the drugs used. In addition to cough, shortness of breath, excessive sweating, paresthesias of the limbs, dryness and peeling of the skin appear.
• Cardiac or respiratory pathologies. In this case, the cough urge occurs on the background of chest pain, shortness of breath, heart palpitations and fever.
• If the implantation of a pacemaker was after coronary artery disease or heart attack, then the cough may be a symptom of pulmonary embolism.

In order to determine what really caused the cough, you should undergo a medical examination with a comprehensive diagnosis of the heart muscle and lungs.

[10], [11], [12], [13], [14], [15]

Medication after installing a pacemaker

To speed up the recovery process after implantation of the EKS and reduce the risk of complications at the time of engraftment of the device, drug therapy is indicated. Consider the main groups of medications that are prescribed after installing a pacemaker.

To thin the blood - drugs reduce the risk of blood clots (clots) that clog the veins and blood vessels.

• Aspirin Cardio

It belongs to the pharmacological group of NSAIDs, inhibits the production of inflammation hormones, relieves pain, and slows down the processes of aggregation and adhesion of platelets.

• Indications for use: the risk of excessive blood clots, prevention of coronary heart disease, unstable angina, myocardial infarction, stroke, recent heart surgery or vessels. Transient disorders of cerebral circulation, cerebral ischemic disease, pulmonary infarction, thrombophlebitis, pulmonary thromboembolism.
• How to use: orally, squeezed liquid. The dosage and duration of treatment is determined by the attending physician, individually for each patient.
• Side effects: epigastric pain, bloating, cramping, peptic ulcer, pancreatitis, anorexia. Allergic skin reactions, dizziness and headaches, reduced renal excretory function, bronchospasms.
• Contraindications: hypersensitivity to the components of the drug, aspirin asthma and triad, ulcerative lesions of the gastrointestinal tract, liver cirrhosis, pregnancy and lactation.
• Overdose: dyspepsia and headaches, impaired consciousness, vomiting. Symptomatic treatment with gastric lavage and sorbents.

Aspirin-cardio is available in the form of oral enteric-coated tablets at a dosage of 100 and 300 mg.

• Cardiomagnyl

Drug with a combined composition. Contains acetylsalicylic acid and magnesium hydroxide. It has analgesic, anti-inflammatory and antipyretic properties. Reduces the risk of blood clots.

• Indications for use: ischemic heart disease of acute or chronic forms, prevention of thrombosis and cardiovascular diseases. Arterial hypertension, hypercholesterolemia.
• Dosing: oral 150 mg per day. Maintenance dose - 1 tablet per day. The course of treatment is determined by the attending physician, individually for each patient.
• Side effects: increased risk of bleeding, decreased platelet aggregation, neutropenia, hypoglycemia, headaches, insomnia, tinnitus, heartburn, nausea and vomiting.
• Contraindications: individual intolerance to the components of the drug, the risk of bronchospasm, the tendency to develop bleeding, in the first days after surgery. The drug is prohibited in the third trimester of pregnancy.
• Overdose: headaches and dizziness, loss of hearing and vision, excessive sweating, nausea and vomiting, respiratory collapse.

Cardiomagnyl is available in the form of enteric coated tablets.

• Thromboth ACC

Antiplatelet drug with the active ingredient - acetylsalicylic acid. Refers to the pharmacological group of NSAIDs. It has anti-inflammatory and analgesic properties.

• Indications for use: treatment and prevention of cardiovascular diseases, complex treatment for unstable angina, prevention of myocardial infarction, secondary prevention of heart attack and stroke. Prevention of pulmonary embolism, cerebral circulatory disorders.
• Method of application: tablets are taken orally with water. Capsules must not be crushed, swallowed or crushed. Daily dosage of 50-100 mg, the course of treatment is determined by the attending physician.
• Side effects: nausea, vomiting, heartburn, pain in the epigastric region, ulcerative lesions of the gastric mucosa and duodenal ulcer. Headaches, dizziness, tinnitus, and allergic reactions are also possible.
• Contraindications: hypersensitivity to the components of the drug, erosive and ulcerative lesions of the gastrointestinal tract, bronchial asthma, pediatric patients, hemorrhagic diathesis. Use during pregnancy is not recommended.
• Overdose: tinnitus, headaches and dizziness, indigestion. Symptomatic treatment with mandatory dosage adjustment.

The drug is available in the form of enteric-coated tablets.

• Lospirin

Drug that has anti-aggregation effects on platelets. Normalizes rheological factors of blood. Reduces the risk of myocardial infarction.

The drug contains an active ingredient - acetylsalicylic acid. It does not belong to selective cyclooxygenase inhibitors, reduces the production of gastroprotective prostaglandins.

• Indications for use: prevention of myocardial infarction in angina, secondary prevention of heart attack. Prevention of development of embolism and thrombosis, impaired cerebral blood flow in ischemic type.
• How to use: orally after a meal, drinking plenty of fluids. Tablets are forbidden to chew or crush. The dosage depends on the indications for use, on average it is 75-300 mg per day.
• Side effects: a violation of the chair, nausea and vomiting, iron deficiency anemia, thrombocytopenia, allergic reactions.
• Contraindications: intolerance to salicylates and drug components. Blood coagulation pathologies, hemophilia, thrombocytopenia, bronchial asthma, liver disease, pediatric practice. Use during pregnancy is possible only in terms of vital signs.
• Overdose: impairment of hearing and vision, confusion, fever, vomiting, dizziness. Symptomatic treatment.

Lospirin has a tablet form of release of 10 capsules in a blister with 3 blisters per pack.

For the prevention of atrial fibrillation and stroke.

• Propanorm

Antiarrhythmic drug for the treatment of supraventricular and ventricular cardiac arrhythmias. Blocks slow calcium channels of cardiomyocytes.

• Indications for use: prevention of attacks of ventricular and atrial arrhythmias. Ventricular extrasystoles, Clerk's syndrome and WPW syndrome, ventricular tachycardia.
• The method of administration and dosage is determined by the attending physician, individually for each patient. On average, the drug is taken at 450-600 mg per day.
• Side effects: dyspeptic disorders, headaches and dizziness, sleep disturbance, reduced visual acuity. Allergic reactions, blood rheology in the direction of increased bleeding are also possible. Overdose has similar symptoms. Treatment consists of detoxification measures with further symptomatic therapy.
• Contraindications: hypersensitivity to the components of the drug, uncontrolled heart failure, cardiac glycoside intoxication, cardiogenic shock. It is used with extreme caution in cases of arterial hypotension and bradycardia. Use during pregnancy and lactation is prohibited.

Propanorm is available in tablet release form for oral administration.

• Cats

Antiarrhythmic drug class III with antianginal and antiarrhythmic properties.

• Indications for use: paroxysmal tachycardia, ventricular / supraventricular paroxysmal tachycardia, atrial fibrillation and atrial flutter. Prevention of the above conditions.
• The method of application depends on the form of release of the drug. Tablets take 600-800 mg per day, gradually increasing the total dosage to 10 g. The duration of treatment is individual for each patient.
• Side effects: lipofuscin deposition in the corneal epithelium, dermatological reactions, respiratory failure, neutropathy, extremity tremor, bradycardia, hypotension. Overdose has similar symptoms.
• Contraindications: intolerance to the components of the drug, sick sinus syndrome, impaired atrioventricular and intraventricular conduction, the absence of a pacemaker. Thyroid dysfunction, pregnancy and lactation, patients under 18 years of age.

Cordarone is available in the form of tablets and solution for intravenous injection.

• Xarelto

Contains the active ingredient - rivaroxaban from the group of Xa factor inhibitors with high bioavailability when administered.

• Indications for use: reduction of the risk of stroke, atrial pathology, arrhythmia of non-valvular origin, deep vein thrombosis, pulmonary artery blockage, prolonged immobilization, prosthetics.
• Method of application: parenterally with food or 20 minutes before it. Daily dosage of 20 mg, with primary pathologies of 15 mg. The course of treatment of thromboembolism and thrombosis is 21 days. In other cases, the duration of therapy is determined by the attending physician.
• Side effects: arterial hypotension, anemia, tachycardia, bleeding, dyspepsia, disorders of the liver and kidneys, skin allergic reactions.
• Contraindications: heavy bleeding and predisposition to them, liver and kidney disease, lactase deficiency, patients under 18 years of age. The drug is prohibited during pregnancy and lactation.
• Overdose: bleeding, allergic reactions, impaired kidney function. Symptomatic treatment with drug withdrawal.

Form release: tablets with an enteric coating of 2.5, 10, 15 or 20 mg of the active ingredient.

• Acquire

Antihypertensive drug with the active component - hinapril hydrochloride. Inhibits the activity of the angiotensin-converting enzyme, activates the depressor systems that realize the vasodilator effect.

• Indications for use: heart failure, persistent increase in blood pressure.
• Method of application: oral 100 mg 1-2 times a day, if necessary, the dosage can be increased twice. The maximum single dose of 200 mg, and 400 mg daily. The course of treatment is determined by the doctor.
• Side effects: headaches and dizziness, a sharp drop in blood pressure during the transition from horizontal to vertical position, exacerbation of ischemia, tinnitus, coughing episodes, nausea, allergic reactions.
• Contraindications: intolerance to the components of the drug, predisposition to edema, narrowing of the renal arteries and aorta, narrowing of the mitral valve, pregnancy and lactation, patients under 14 years of age.

Akkupro has the tablet form of release in a dosage of 50, 100 and 200 mg.

[16], [17], [18], [19], [20], [21],

Anticoagulants and antiplatelet drugs - reduce the risk of blood clots and are prescribed for atrial fibrillation.

• Quinidine

It is used to prevent and relieve attacks of atrial fibrillation, with paroxysmal supraventricular tachycardia, extrasystole, ventricular tachycardia, and other heart rhythm disorders. The medicine is taken 1 tablet 2-3 times a day. The optimal dosage selects the attending physician.

The drug is contraindicated in case of intolerance to its components, cardiac decompensation, during pregnancy and lactation. Side effects are manifested by inhibition of cardiac activity, nausea and vomiting, diarrhea, allergic reactions. In severe cases, atrial fibrillation is possible. Quinidine is available only in tablet release form.

• Novokainamid

Reduces the excitability of the heart muscle, suppressing ectopic foci of excitation. Used for various heart rhythm disorders. Dosage and treatment are determined by the attending physician.

The drug can cause the following side effects: a sharp decrease in blood pressure, nausea, headaches and sleep disturbances, and general weakness. The tool is contraindicated in severe heart failure, hypersensitivity to the components of the drug and a violation of the conductivity of the heart.

Novocainamide has several forms of release: tablets for oral administration of 250 and 500 mg, 5 ml ampoules of 10% solution for intravenous administration

• Dizopyramide

Antiarrhythmic agent from the category of antiarrhythmics IA class. Reduces the heart rate, lowers systolic blood pressure. It is used in atrial and ventricular premature beats, cardiac arrhythmias. The method of administration and dosage is determined by the attending physician. The drug is available in capsules of 100 mg and in the form of a 1% solution in 5 ml ampoules for injection.

• the fascination

Antiarrhythmic agent. It is used to treat and prevent such conditions:

• Atrial and ventricular premature beats.
• Paroxysmal tachycardia.
• Arrhythmias caused by digitalis intoxication.
• Acute myocardial infarction.

The drug is administered intramuscularly and intravenously in 2 ml of a 2.5% solution, diluted in 10 ml of an isotonic solution of sodium chloride or 5% glucose solution.

Side effects are manifested by increased weakness, nausea and bouts of vomiting. It is also possible to lower blood pressure, allergic reactions and a sensation of heat at the injection site of the drug.

Aymalin is contraindicated in severe disorders of the cardiac conduction system, severe heart failure, hypotension, and inflammatory changes in the heart muscle.

[22], [23], [24]

Beta-adrenergic blockers - used for sinus bradycardia and high heart rate in the background of the EX.

• Propranolol

Beta-blocker of indiscriminate action. Reduces strength and heart rate. Decreases myocardial contractility and cardiac output, reducing myocardial oxygen demand. Restores blood pressure and increases the tone of the bronchi. Reduces the risk of bleeding in the postoperative period.

It is used for coronary heart disease, heart rhythm disorders, some forms of coronary disease and sinus tachycardia.

• Osprenolol

Non-selective beta-blocker with sympathomimetic activity. It has anti-ischemic, antiarrhythmic and blood pressure lowering properties. It is used for hypertension, angina attacks. Reduces the risk of myocardial infarction. Suppresses functional cardiovascular disorders, provoked by over-stimulation of the sympathetic nervous system.

• Pindol

Non-bioselective betaadrenergic blocker with blood pressure lowering properties. It is used for hypertension and hypertensive crisis. The medicine is started on a dosage of 5 mg 2-3 times a day, gradually increasing the dose to 45 mg per day. For intravenous use, 2 ml of a 0.02% solution is used with constant monitoring of blood pressure.

• Alprenolol

Non-selective long-acting beta-blocker, does not have a pronounced effect on heart contractions. It is used for angina, atrial and ventricular arrhythmia, heart rhythm disturbances due to cardiac glycosides, as well as with a steady rise in blood pressure. The drug is taken on 50 mg 3-4 times a day, the duration of treatment depends on the effectiveness in the first days of therapy.

In addition to the above drugs, in the postoperative period, patients may be prescribed antibiotics, painkillers, anti-inflammatory and other drugs. As for the possibility of further drug therapy with a pacemaker, there are no restrictions. The device allows you to take any medication, but only for medical purposes.

[25], [26], [27], [28], [29], [30]