Life with a pacemaker: what can and can not be done?

At first, after installing the EKS, the patient's life changes significantly. This is due to certain limitations and a long rehabilitation period. Consider what to face after a pacemaker implantation:

• The entire first week after surgery, patients spend in the hospital under medical supervision. This is necessary for monitoring heart rate and post-operative wound care.
• If healing occurs without complications, and the device works in the prescribed mode, the patient is discharged home. For further rehabilitation, the doctor opens a sick-list.
• The first month after surgery, you must adhere to moderate physical exertion. Also shown are regular visits by a cardiologist to assess the condition of the scar and the work of an EX. If everything is normal, then the next examination by a doctor should be after 3 months, then after six months and a year.

Pacemaker imposes restrictions on the use of electronic devices. It is not recommended to talk on a mobile phone for a long time, pass through a metal detector or expose yourself to electromagnetic / magnetic radiation.

However, many patients do not notice significant changes in lifestyle after the implantation of the EX. Athletes can continue to continue to play sports (after rehabilitation in 2-3 months), and all restrictions in work are reduced to minimizing the effects of radiation that can disrupt the apparatus. Also, systematic examinations by a cardiologist, a healthy diet and a positive psychological attitude are added to the usual rhythm of life.

How to use a pacemaker?

Many patients who have an artificial pacemaker installed are wondering how to use it. So, first of all it should be noted that all the settings regarding the functioning of the device, that is, its stimulation, are performed by the doctor during the operation.

The doctor selects the desired mode of operation and tests it. The patient cannot independently make any changes. The use of a pacemaker is reduced to its preservation from mechanical traumatization. Everything else the device does independently in automatic mode.

Restrictions

Medical devices to maintain the rhythm of the heart as much as possible adapted to the conditions of modern life. Restrictions for patients with a pacemaker are few, but they need to be followed.

Consider the basic prohibitions for owners of EX:

• Expose to powerful electromagnetic or magnetic fields.
• To conduct ultrasound with the direction of the beam apparatus on the body of an artificial pacemaker.
• To injure the chest area.
• Attempt to dislodge or rotate the instrument housing under the skin.
• It is not recommended to be in the same room with a working microwave, that is, a microwave oven.
• Pass through the framework of metal detectors.
• Conduct magnetic resonance imaging if the stimulator is not marked MRI.
• Use physiotherapy methods of treatment: magnetic therapy, microwave therapy.
• Long stay in the bath or sauna.

In addition to the above restrictions, you should minimize the time of using a mobile phone. In this case, patients can engage in physical education and sports, use a computer, perform X-ray studies and computed tomography.

Pacemaker syndrome

The complex of psychological symptoms resulting from the effects of negative hemodynamics or the electrophysical factors of an artificial pacemaker on the body is a pacemaker syndrome (pacemaker). This disorder occurs in 7-10% of cases and is associated with a decrease in cardiac output.

Symptoms of the syndrome:

• Congestive heart failure.
• Disturbance of breath, shortness of breath.
• Reducing blood pressure to critical values.
• Significant fluctuations in blood pressure during the day.
• Headaches.
• Fainting.
• Decreased visual acuity and hearing.
• Violation of cerebral circulation.
• Cardiomyopathy.
• Induced cardiostimulation with dilatation of the left ventricle and a decrease in its ejection fraction.

The appearance of a painful symptom is associated with many factors, but most often due to such reasons:

• Asynchrony of the atria and ventricles.
• The injection of blood into the pulmonary and hollow veins due to atrial contraction with the tricuspid and mitral valves closed.
• Retrograde impulse conduction to the atria.
• The frequency of stimulation EX-does not correspond to the optimal heart rate.

To diagnose the pacemaker syndrome, the patient is monitored daily for heart function and blood pressure levels using an ECG.

In order to eliminate the syndrome, it is necessary to change the mode of cardiac stimulation by choosing a function that best suits the physiological work of the heart. There is also a change in the fundamental frequency and frequency adaptation function. Drug therapy is mandatory.

Pacemaker load

One of the most common questions for patients who have been sutured with EKS is the possibility of stress. Installing a pacemaker implies significant limitations on any activity in the first months after surgery. This is due to the fact that the electrodes, like the body itself, must take root in the body.

During this period active sport and weight lifting is contraindicated. Also banned tight clothing that clamps the body and can cause skin irritation at the site of attachment of the apparatus or its electrodes.

In this case, it is absolutely impossible to specifically restrict movement in the shoulder joint. Since prolonged immobilization can lead to the development of arthrosis and a number of other pathologies. Recommended therapeutic gymnastics, which consists of smooth, slow movements. Returning to normal life and work takes about 2-3 months after surgery.

High pulse with pacemaker

Implantation of an artificial heart rhythm driver contributes to the normalization of both slow and rapid pulse due to frequency adaptation. If the high pulse is within the normal range of the established mode, then this is not a cause for concern.

But if the heart rate does not change with increasing load, then it is worth contacting a cardiologist. The doctor will reconfigure the device. Most often, this problem is experienced by patients whose heart does not maintain its own rhythm.

Dyspnea with pacemaker

The appearance of respiratory failure in patients with an artificial pacemaker is extremely rare. As a rule, patients on the contrary note the disappearance of shortness of breath after installing a pacemaker.

Possible causes of shortness of breath:

• Wrong stimulation mode.
• Heart diseases and other lesions of the body.
• Neurological pathology.
• Damage to the electrodes of the device.
• Battery discharge EX.
• Excessive exercise.

If a respiratory failure occurs a couple of months after the pacemaker is installed and persists, then you should consult a cardiologist. The doctor will conduct a comprehensive examination and establish the true cause of the unpleasant symptom.

[1], [2], [3]

How to behave after installing a pacemaker?

Implantation of an artificial heart rate driver is a real test, both from a physiological and psychological point of view. After the operation, almost all patients ask themselves how to behave, what habits should be changed and how to build a future life.

Installing a pacemaker imposes certain restrictions on previously familiar life, but they are not significant. The main recommendations for patients include:

• Medical studies using electromagnetic radiation (MRI, diathermy, electrocoagulation, external defibrillation) can adversely affect the operation of the device, so they are prohibited.
• You can not be near sources of electrical current or electromagnetic radiation. It is better to carry a mobile phone in a pocket of trousers, and not in a breastplate.
• The chest should be protected from injury to avoid damage to the EX.
• Physical activity is allowed, as is any work that is not related to electromagnetic radiation or an increased risk of injury.

Also, patients need to change their diet in the direction of healthy food. It would not be superfluous to take multivitamin complexes and dietary supplements to increase the protective properties of the immune system.

What can not be done with a pacemaker?

After installing an artificial heart rhythm driver, the patient will face a number of restrictions that should be adhered to in order not to harm the pacemaker.

The prohibition category includes:

• Wearing a mobile phone or magnets near the chest.
• The presence in the range of devices that generate electromagnetic waves: motion sensors, anti-theft detectors.
• Frames of metal detectors and scanners of the whole body at the airport, at railway stations.
• Magnetic resonance imaging and a number of other medical procedures.
• Work related to electric arc welding.
• Radiation treatment of cancer.
• Trauma to the chest or attempts to independently change the position of the implant.

Implementation of the above recommendations does not cause difficulties, but allows you to return to a full life without serious problems.

Is it possible with a pacemaker:

The presence in the body of a medical device for maintaining heart rhythm has a number of contraindications, both relative and absolute, which all patients must adhere to. Consider what is prohibited and what can be done with a pacemaker.

Do x-ray

Radiography refers to the approved diagnostic methods for patients with EX. In addition, it is the X-ray that reveals the mixing or breakage of the electrodes of the device.

It should also be noted that the operation to implant a pacemaker is under the control of X-rays. That is, x-rays, like fluorography, have no limitations on implants in the heart.

[4], [5], [6], [7]

Massage

Very often after installing the EX-patients are recorded on massage courses to keep the body in good shape. But to do a massage with a pacemaker is not recommended. The procedure is permitted if performed away from the sternum and does not cause heart rhythm malfunctions.

With regard to the use of percussion techniques or electric massage tools, it is prohibited. Massage techniques should be as gentle as possible. Also, before the procedure should consult with your doctor. The doctor will assess the general state of health and, if necessary, give directions for a massage or prescribe other, safer methods of exercise therapy.

Do an MRI

MRI involves the use of a magnetic field that affects electronic devices and can damage an implant. That is why magnetic resonance imaging is included in the list of contraindications for patients with permanent EX. If necessary, this examination, it is replaced by x-rays or computed tomography.

Many modern models of pacemakers are MRI compatible. That is, the devices do not fail when exposed to a magnetic field. In this case, before performing the diagnosis, the doctor must make sure that the EKS is properly configured. After passing the study, the settings return to normal.

[8], [9], [10]

Do CT

The presence of a pacemaker is not a contraindication for computed tomography. Irradiation of the device does not affect the work of the implant.

But before the procedure, the doctor should be warned about the presence of a device in the heart. This is necessary so that the doctor adjusted the dose of contrast enhancement and chose the best way to work CT. In addition, ultrasound and CT are an alternative to MRI.

[11], [12], [13], [14]

Do ultrasound

One of the most common diagnostic methods is ultrasound. Ultrasound refers to non-invasive techniques, allowing to obtain an image of the required organ in different projections.

It is possible to do ultrasounds with an artificial heart rate driver if the sensor of the device does not pass over the area where the ECS is stitched.

[15], [16], [17], [18]

Wear fitness bracelet

The long recovery period after implantation of the ECS involves the use of various devices to track physical activity. Wearing a fitness bracelet with a pacemaker is not only allowed, but also recommended by many rehabilitators.

Fitness bracelets are absolutely safe, they do not cause any adverse reactions and do not affect the work of the implant. The bracelet collects information about physical activity during the day and about the quality of sleep.

In addition, the device counts the number of calories burned, and some models control the heart rate. Many patients note that wearing the device promotes a healthy lifestyle and speeds up the rehabilitation process.

Do mammography

Mammographic screening, both for diagnostic and prophylactic purposes, is permitted for patients by an artificial pacemaker. For mammography such diagnostic methods can be used:

• X-ray - rays pass through the tissue, giving the image of the mammary glands. It is the gold standard in detecting breast cancer.
• Computed tomography is a clarifying method that is included in the mammography complex. The study is conducted using a movable x-ray emitter. Due to this, the doctor receives a layered image of the mammary glands with detailed information about each layer.
• Ultrasound - a painless method that allows you to get an image of the gland in different projections. Detects any neoplasms in tissues and other changes in the structure of the organ.

All of the above methods are allowed for patients with EX.A. But before conducting the study, the doctor should be warned about the presence of an implant.

[19], [20], [21]

Go to the bath

Visiting a steam room or a bath in the first months after installing a pacemaker is contraindicated. With the recovery, after about 3-4 months, you can briefly enter the bath and not so much to steam, to avoid overheating.

At the same time, the presence of an EX-is an absolute contraindication for visiting the infrared sauna. Also, you should not abruptly start going to the bath and stay in the steam room for a long time, if you did not do this before installing the EKS. Since sudden changes in temperature can adversely affect the state of health.

Drink alcohol

The number of restrictions after installing an artificial pacemaker is the use of alcohol. Drinking alcohol with a pacemaker should be extremely cautious and only with good health. The abuse of strong drinks is dangerous by the development of such pathologies:

• Arrhythmia.
• Hypertension.
• Heart failure.
• Cardiomeopathy.
• Exacerbation of chronic diseases.

It should be borne in mind that alcohol causes a heart rhythm disorder, which is corrected by a pacemaker.

The World Health Organization recommends that you use no more than 30 ml for men and 15-20 ml for women in terms of pure alcohol. This is about 200 ml of dry wine, 74 ml of 40-degree vodka and about 600 ml of beer. If you stick to these doses, alcohol will have a prophylactic effect on the heart.

[22], [23], [24]

To go in for sports, gymnastics, exercise therapy

The presence of an artificial heart rhythm driver is not a contraindication for playing sports. Of course, in the postoperative period, physical activity should be minimized, but as the recovery should be increased load.

Do not forget about a number of rules that will allow you to protect yourself from the adverse symptoms of sports:

• Eliminate increased stress on the muscles of the upper body.
• Minimize the risk of pressure or shock to the FORMER area. That is, the occupation of various martial arts and weightlifting should be limited.
• Shooting from a gun is banned.
• Such game sports as basketball, hockey, football and volleyball are not recommended. Excessive amplitude of the hands can lead to the separation of the electrodes from the heart, and trauma to the sternum can lead to implant failure.

Allowed to engage in gymnastics, swimming and dancing. Walking is safe and helpful. You should also protect the installation site of the EKS from direct sunlight and do not swim in cold water.

Have sex

Intimacy after installing an artificial heart rhythm driver refers to physical exertion. Having sex can be after discharge from the hospital and with normal health. But despite this, many patients are afraid of this kind of stress, although the heart during sex is strained no more than after a run or morning gymnastics.

In order for patients to feel more confident, doctors have made a scheme that allows you to independently determine when it is possible to restore intimacy.

• Sex is contraindicated within a month after the last heart attack.
• After inserting EX, you can have sex no sooner than a week later, that is, after discharge from the hospital.
• After surgery on the heart valves, the patient needs to wait until the chest has fully healed, it takes 1.5-2 months.

But if pronounced pain in the chest appeared when all the recommendations were followed after sex, you should immediately consult a doctor, and in severe cases - call an ambulance.

Fly on a plane

Air travel for people with implanted pacemakers is permitted. The only danger is the framework of metal detectors with a contour of a closed type. Their magnetic field has a bad effect on the ECS and can cause disturbances in its operation. Medicine is the case when the passage of a magnetic frame at the airport put the heart rhythm stimulator down and the person died.

In order to protect yourself from passing metal detectors, it is recommended that you register as an invalid when purchasing a plane ticket and warn the airline in advance about the presence of a pacemaker. In this case, when passing through the control, it will be enough to show the passport of the device and go through a personal inspection. During the flight, you should wrap the seat belt with a soft jacket or towel so that it does not put pressure on the implant.

[25], [26], [27]

Work with computer

According to the research, a personal computer and peripheral computer equipment (printer, modem, scanner, fax) do not carry any danger for the owners of the ECS. That is, you can work with a computer with a pacemaker. It is necessary that the system unit with all its electronic internals stand at least a meter away from the installation site of the EKS.

The rest of the rules for working with PCs are the same as for people without a wired machine. First of all, you should not sit for a long time at the monitor, as this badly affects the state of the organs of vision. It is also recommended to do a little warm-up and eye exercises every two hours.

Work as a driver

A medical device supporting heart rhythm is not a contraindication for driving a car. That is, it is possible to work as a driver after an EX. In addition, the presence of the device prevents the development of cardiac arrhythmias, fainting and loss of consciousness, which are contraindications for obtaining a driver's license.

Also, the device does not limit the movement of the patient in transport. Traveling in buses, trams, trains and subways are not dangerous. Particular attention should be paid to travel by plane, or rather the passage of metal detectors at the airport. In the presence of an EKS, you must provide a passport of the device and not expose yourself to the effects of closed magnetic radiation, which can damage the implant.

Do an ECG

A diagnostic method that determines the functional state of the heart is an electrocardiogram. The essence of the study in the study of electrical currents that occur during the operation of the heart. The advantage of ECG is the availability and ease of holding.

Doing an ECG with a pacemaker is not just possible, but necessary. The device is necessary to determine such indicators:

• Heart rate.
• The presence of arrhythmias.
• Myocardial damage (acute, chronic).
• Exchange disorders in the heart.
• Violation of the electrical conductivity of the body.
• Determination of the electrical axis of the heart muscle.

The ECG is performed in the first week after the implantation of the EKS, as well as during scheduled visits to a cardiologist.

[28], [29], [30], [31], [32]

Put a halter

Holter monitoring is a diagnostic method in which an electrocardiogram is attached to the body for a day. The study is conducted with complaints of interruptions in the work of the heart, with frequent dizziness and fainting, sharp chest pains and increased weakness.

Putting a halter with a pacemaker is allowed. The device allows you to track the work of an artificial pacemaker and, if necessary, change the mode of its stimulation. Holter is used in cases of suspected malfunction of the ECS, as well as during scheduled inspections.

Work in the garden

Installing an artificial heart rate driver imposes certain restrictions on physical activity. But contraindications to stress relate to the first months of rehabilitation. In the future, you need to gradually return to the usual way of life.

That is, it is possible to work in the garden with an EX, but jerking movements and overvoltage should be avoided. You also need to protect yourself from all sorts of blows the area of the implant, so as not to damage it.

Pacemaker and metal detector at the airport: how to behave and what to do?

The main danger for patients with artificial pacemakers is the framework of metal detectors that are installed at the airport. Unlike store magnetic frames, devices with a strong magnetic field are installed at the airport. When passing through the frame or when viewed with a hand-held metal detector, there is a high risk of disturbing the normal operation of the ECS. In addition, deaths due to the passage of a metal detector are recorded in the world.

In order to protect yourself, you must adhere to these rules:

• Always carry a patient card and passport device.
• Avoid installation locations of magnetic frames, detectors and metal detectors.
• Notify the airport staff in advance of the presence of a pacemaker. In this case, conduct a personal search.

When buying a plane ticket, during registration you should definitely select the status Disabled, that is, disabled. As for the flight itself, it is not dangerous for people with pacemakers.

Diet after installing a pacemaker

The diet after installing a medical device to maintain heart rate should be based on the principles of healthy eating. Patients prescribed diet number 15 - a common table. Its main goal is to provide the body with physiologically adequate nutrition for its normal functioning.

The chemical composition and caloric content fully meet the standards for a healthy person.

• Proteins 70-80 g - 55% of animal and 45% of plant origin.
• Fat 80-85 g - 30% of plant and 70% of animal origin.
• Carbohydrates 350-400 g.
• Salt 10-12 g
• Purified water 1.5-2 liters.
• Calories: 2500-2900 kcal.

Hard-to-digest foods, fatty meats and fish, spicy seasonings and sauces, refractory animal fats are excluded from the diet. The basis should be cereals, fresh meat and fish, dairy products and eggs, dairy drinks, pasta from durum wheat, fruits and vegetables, and various flour products.

In the diet you can include sausages, wieners, butter or vegetable oil, a small amount of confectionery. Eating should be fractional, that is, in small portions throughout the day, so that the body does not experience hunger. Enough 3 main meals and 2-3 snack.

[33], [34], [35]

Pregnancy with a pacemaker

The presence of an artificial heart rate driver is not a contraindication for pregnancy. Even at the planning stage, one should undergo a comprehensive examination and obtain a conclusion from a cardiologist and an arrhythmologist that carrying a child has no contraindications.

In this case, all pregnancy with a pacemaker should be under the control of a cardiologist and an obstetrician. Such medical precautions are associated with an increase in the load on the entire body, and especially on the heart. Because of this, there is a certain risk of developing heart failure and other adverse symptoms.

As for the installation or replacement of the EKS during pregnancy, then if there are appropriate indications, the procedure is carried out, but only up to 30 weeks of gestation. The presence of a pacemaker is not a ban on abortion, that is, an abortion. Difficulties may occur when using coagulators that affect the magnetic field.

Childbirth with a pacemaker

Pregnancy with an artificial pacemaker has certain characteristics, but as a rule it runs smoothly. The task of women in advance to prepare for the generic process. First of all, you should agree with the cardiologist, because his presence at birth is necessary. It is also necessary to conclude a contract for childbirth with an obstetrician-gynecologist and choose a maternity hospital that can take women in labor with an EKS.

The delivery itself is carried out by caesarean section. This is due to the fact that natural childbirth is a dangerous load for the cardiovascular system. In order to maximally secure the future mother and child, almost all doctors recommend the surgical method of birth.

[36], [37], [38], [39]

Pacemaker and magnets

The main rule for patients with implanted EX-is to ban the use or being near the sources of magnetic or electromagnetic radiation.

Electromagnetic interference can cause malfunctions in the device, provoke its transition to the mode of inhibition or stimulation with a fixed frequency. There is also a risk of damage to the electronic circuit and the device failure, which can lead to death.

Attaching magnets directly to the pacemaker implantation area is prohibited. Such actions lead to a failure of the stimulation mode. Moreover, the violation lasts exactly as long as the magnet is located near the chest. Special attention should be paid to garments and accessories that may contain magnets.

Pacemaker Removal

There are several indications for the removal of an artificial pacemaker:

• Battery replacement.
• Damage to the device or its electrodes.
• The development of life-threatening complications.
• Restoration of the physiological work of the heart.

Removal of a pacemaker can be performed with or without electrodes. During the operation, the doctor cuts the bed of the ECS and takes it out of the chest.

As for the explantation of long-term implanted wires, they are removed in the absence of serious risks to the patient. If there is a chance of rupture of the heart or damage to the vascular walls, the electrodes are not withdrawn. Their presence in a vein does not represent any danger to the patient.

Pacemaker certificate

After being discharged from the hospital about the operation of installing an artificial pacemaker, the patient is issued a certificate of the presence of an ECS and a passport for the device itself.

The issuance of a certificate is mandatory, since the implant has a number of restrictions that must be adhered to. First of all, it is a refusal to pass metal detectors at airports and railway stations. In this case, an official document reduces the risk of premature failure of a medical device.

Disability group after installing a pacemaker

Disability is a medico-social category, therefore granting the status of a disabled person requires serious reasons. It is not given automatically immediately after the operation.

To obtain a disability after implantation of a pacemaker, you must consult your doctor. The doctor will collect a commission, which will decide in this matter. The commission guides the patient's level of dependence on ECS and the general condition of the body.

If the device does not have an absolute dependence on life, then disabled status is not granted. If the commission made a positive decision, then a third or second temporary or permanent disability can be established. The third group is working, and the second has a number of restrictions regarding work. At the same time, patients do not receive the complete inoperability status.

[40], [41], [42], [43], [44]

How many people live with a pacemaker?

Very often, patients ask how life expectancy changes in the presence of a cardiac implant to stimulate rhythm.

• First of all it depends on the duration of the pacemaker. On average, the device is able to work for 7-10 years, with about a year being spent on scarring of tissues, the full engraftment of the ECS and the rehabilitation period.
• From a medical point of view, the duration of life with the device is determined by the general state of health. The main task of an artificial pacemaker is to prevent death due to a heart attack, blockade, or arrhythmia.
• With regular checks at the cardiologist, timely replacement of the battery EX and compliance with all medical recommendations, life expectancy is much longer than people without a device. But the exact answer to the question: how long a person can live with a pacemaker can not one doctor.

As for the death of people with cardiac implants, it takes longer. This is due to the fact that the ECS sends impulses to a stopped heart, causing it to beat. Death comes hard and long, but at the same time the strength of the device is not enough to launch an organ that is not able to contract on its own.

Death due to unconfigured pacemaker

There are cases in medicine when an incorrect mode of operation, a failure in the settings, or a mechanical trauma of an artificial pacemaker resulted in the death of a patient. This category also includes the discharge of a device's battery, when a patient with a severe form of heart disease delays the replacement of a battery.

In order to minimize the development of severe adverse reactions and death from incorrect work of the pacemaker, the patient must regularly undergo cardiac examinations. The device is checked by the programmer, which, if necessary, corrects the mode of stimulation, eliminating the problem.

In order to protect oneself from death due to a faulty EKS, it is impossible to pass through the framework of metal detectors at airports and be located near sources of magnetic or electromagnetic radiation. Should strictly adhere to all restrictions regarding the cardiological apparatus.

[45], [46]