Pacemaker Operation: Pros and Cons

To maintain the functioning of the heart, a special device is used - a pacemaker. Consider the features of this unit, types, indications for use.

The heart is the motor of our body. It is a fibrous muscular hollow organ, which with its rhythmic contractions provides blood flow through the blood vessels. A powerful muscle located in the chest. Outside, the heart is surrounded by a serous membrane, and from the inside by the endocardium. The organ has two partitions of muscle tissue, as well as membranes, creating four different sections: the left and right ventricles, the left and right atrium.

Normally, a person does not notice how the heart works. But as soon as interruptions occur in the organ, this negatively affects the functioning of the whole organism. A sick heart is not able to provide normal blood flow due to which side reactions from many organs and systems occur. For treatment, that is, the restoration of the work of the heart, use both therapeutic and surgical techniques. The latter include the installation of an artificial pacemaker.

So, a pacemaker is a medical electrical device that imposes a correct sinus rhythm on the heart. The main indications for the installation of this device are such diseases:

• Severe bradycardia.
• Complete heart block (ventricles and atria contract independently of each other).
• Severe heart failure.
• Cardiomyopathy (structural impairment of muscle contractility).

As a rule, the device is implanted in the left subclavian area under the pectoralis major muscle. Electrodes are carried out to the chambers of the heart through the subclavian vein and fixed to the surrounding tissues. After you install a heart rate stimulator, a person's life changes. There are a number of restrictions and requirements. But despite this, the device will allow you to lead a full life.

What is it and what happens?

A pacemaker is an electronic device that eliminates cardiac arrhythmia, restores and maintains normal organ function. Its size is no more than a matchbox. It is sewn under the skin, and the electrodes are included in the right atrium. The device imposes to the body a constant beat of 60-65 beats per minute, preventing a decrease in heart rate.

There are several types of pacemakers (EX):

• Single chambers start working when bradycardia appears, that is, a heart rate of 40-50 beats per minute.
• Two-chamber - automatically turn on and constantly monitor the heart rate.
• Triple chambers are used to treat conditions that are life-threatening (severe ventricular arrhythmia).

The device consists of a microprocessor, electrodes, an electric pulse generation system and a battery. All components are packaged in a titanium case, which is completely airtight and practically does not interact with the surrounding tissues. The mechanism is placed in proximity to the heart muscle and connect its electrodes with the myocardium.

Through electrodes, the microprocessor receives information about the electrical activity of the heart and, if necessary, generates pulses. All data on the operation of the device is stored in its memory for further analysis. All EX-infusions are individual for each patient. The doctor sets the base heart rate, below its values is the generation of electrical impulses.

The service life of the device is about 8-10 years. In the future, you may need to re-operation to replace it. In this case, the manufacturer's warranty in most cases is about 4-5 years.

First pacemaker

Annually the number of operations for the installation of pacemakers is growing. And this is not surprising, since the modern device has miniature size and high functionality. Although 10-20 years ago, pacemakers had an impressive size.

For the first time, cardiac pacing was applied by Mark Leadville in 1929. An anesthesiologist described an electrical apparatus that is capable of supporting the functioning of the heart. His device gave electrical discharges of different power and frequency. One electrode was injected directly into the heart, and the second was applied to the skin after treatment with saline.

• The first fully implantable pacemaker was developed in the 1950s and 1960s. This period is considered golden in cardiac pacing. The device was large and completely dependent on external electricity, which was a huge disadvantage. So in 1957, a power outage caused the death of a child who had this device installed.
• In 1958, the first portable stimulant was designed and implanted. It was installed in the abdominal wall, and the electrodes were brought to the heart muscle.
• In 1970, a lithium battery was created, which significantly extended the life of the instrument. During this period, two-chamber stimulators have been invented, affecting the atria and ventricles.
• In the 1990s, the world saw the first ECS with a microprocessor. They allowed to collect and store information about the patient's heart rhythm. In addition, the device could adapt to the body, adjusting the work of the heart and, if necessary, ask it a rhythm.
• In the 2000s, a two-ventricular stimulation system was developed for severe heart failure. As a result, cardiac muscle contractility and patient survival improved.

Today, a pacemaker is a complex mechanism that has three main components:

1. Electronic circuit.
2. Lithium-ion battery.
3. Titanium shell

EX-saves lives of millions of people around the world. Thanks to modern technology, its size is quite tiny. The implantation of the device occurs in several stages, which allows patients not to experience physical or aesthetic discomfort from the mechanism located under the skin.

[1]

Pacemaker functions

The main function of an artificial pacemaker is to control and stimulate the heart muscle. The mechanism is activated if there is a rare or abnormal rhythm, gaps in heart rate.

Pacemaker functions depend on the type of device. The mechanism can be one, two and three-chamber.

• Each stimulating chamber is designed to stimulate one section of the heart. Two-chamber devices stimulate the right ventricle and atrium, and three-chamber devices stimulate the right atrium and both ventricles.
• Cardioresynchronization devices are equipped with touch sensors that track changes in the body.
• Such devices are used in severe forms of heart failure, as they eliminate dyssynchrony, that is, uncoordinated contractions of the heart chambers.

To date, many pacemakers have been developed for a specific type of disorder. This expands the functionality of the device and increases its effectiveness in the treatment of pathologies of the heart.

Indications for the procedure

For the implantation of an artificial heart rhythm driver, the patient undergoes a set of diagnostic examinations that determine how much an EKS is needed. The indications for the pacemaker are absolute and relative. The urgent need to install the device is indicated in the event that serious disturbances in the work of the heart occur:

• Rare pulse.
• Big pauses between heartbeats.
• Sick sinus syndrome.
• Hypersensitivity syndrome carotid sinus.

The above problems occur in the pathology of impulse formation in the sinus node. Similar occurs in congenital diseases and cardiosclerosis.

A permanent pacemaker is installed with such absolute indications:

• Bradycardia with a pronounced symptom complex.
• Morgagni-Adams-Stokes syndrome.
• Heart rate during exercise less than 40 beats per minute.
• ECG asystole over 3 seconds.
• Persistent atrioventricular block II-III degree with two or three-beam blockade.
• Persistent atrioventricular block II-III degree after myocardial infarction and in the presence of pathological symptoms.

With absolute indications, the operation is carried out according to plan after a complex of diagnostic studies or on an emergency basis.

Relative indications for EX:

• Syncopal states with two and three-beam blockades that are not associated with complete transverse blockade or ventricular tachycardias, but the true etiology has not been established.
• Atrioventricular block III degree at any anatomical site with a heart rate of more than 40 beats per minute without any symptoms.
• Regressive atrioventricular block.
• Atrioventricular block II degree of type II without symptoms.

With relative indications, the decision to install the device is made by the doctor, individually for each patient. The doctor takes into account the age of the patient, the presence of concomitant diseases, the level of physical activity.

Pacemakers are set at real risk to the health and life of the patient. To date, most often used two, three and four-chamber model. But with certain indications, single-chamber devices can be implanted.

Pacemaker for atrial fibrillation

Disruption of the normal heart rhythm with a pulse of 300 beats per minute and the chaotic excitation of the muscle fibers of the atria is atrial fibrillation. The main goal of surgical treatment is to restore the heart rate of a normal frequency.

When deciding to implant an EX for stopping paroxysms, it destroys the AV node, that is, a complete AV block is created or ablation of the atrial fibrillation zone in the atria is performed. If this is not done, the pathology will go to the ventricle, which will cause life-threatening tachycardia. Most often, patients install a cardioverter defibrillator or a single-chamber EX with a ventricular electrode.

Also, the patient is prescribed antiarrhythmic drugs, which contribute to the normalization of the heart. A pacemaker with this pathology is effective in 90% of cases, so in some patients the disorder again makes itself felt during the year.

[2]

Heart pacemaker

With pathological changes in the vessels, myocardium and valve apparatus, heart failure develops. The danger of this violation in its rapid progression, the tendency to decompensation and the transition to the chronic form.

Implantation of an artificial pacemaker is possible if the disease has assumed a severe congestive form. Action EX-directed to:

• Elimination of painful symptoms.
• Slowing structural changes in the heart.
• Elimination of functional dysfunction.
• Reduction in hospitalization.
• Increased survival and improved quality of life.

When choosing cardiological equipment, one and two-chamber models are preferred. A cardioverter-defibrillator can also be installed for recurring ventricular arrhythmias that are life-threatening.

Pacemaker after heart attack

The main indication for implantation of a pacemaker after myocardial infarction is stable atrioventricular AV block II-III. At installation of the device it is necessary to consider that EX-changes the data of the cardiogram. Because of this, it becomes impossible to obtain reliable information about the state of the organ.

That is, an artificial pacemaker can mask the symptoms of the disease. In this case, the patient is prescribed a complex of laboratory tests and an ECG check with an EX programmer.

Pacemaker quota

According to the program of the Ministry of Health of Ukraine, annually from the country's budget funds are allocated for the purchase of implantable cardiac devices. The pacemaker quota implies free installation of devices. First of all, this benefit extends to socially unprotected segments of the population.

The order of installation of the EX-quotas is determined by order of the Ministry of Health. A queue for implantation is created in the regional commissions, which select patients who need expensive equipment.

To get a quota for installing a pacemaker, you must:

• Complete a comprehensive cardiological examination and obtain relevant conclusions from the attending physician and the medical consultation commission.
• The WCC submits an application to the Commission of the Ministry of Health, which examines the case of each patient and makes a decision on granting benefits.

In Ukraine, according to quotas, one, two, and three-chamber pacemakers are installed, as well as an EX with a defibrillator function. Operations are carried out in regional centers and the capital, entirely at the expense of the state. Subsequent replacement of the device can be carried out both by quota and at the expense of the patient.

In some cases, patients are given a quota for the device itself with the need to pay for the implant procedure and the subsequent rehabilitation. After installing the pacemaker, the patient is sent back to the VCC to resolve the issue of assigning a disability group.

Preparation

Before the operation to install a permanent artificial pacemaker, the patient undergoes special training. It includes a set of diagnostic procedures:

• Laboratory analyzes.
• Chest X-ray.
• Electrocardiogram.
• Magnetic resonance imaging.

A week before the operation, the patient must stop taking medicines that thin the blood, as well as anti-inflammatory drugs. A patient is shown a special diet of light food that will prepare the body for surgery.

Pacemaker Check

A pacemaker is a complex multi-component device that is a foreign body for the human body. Not only health and general well-being, but also life depend on the correct operation of the device. A systematic check of the artificial pacemaker and the correct setting is the key to its efficient operation.

During the test, the doctor assesses the correct operation of the device, the state of the electrodes, and especially the stimulation settings. Also be sure to check the status of the battery. Primary testing and adjustment are carried out immediately after implantation. If the device is working properly, then the patient is prescribed further scheduled checks:

• 2-3 months after installation. During this time, the body is fully adapted to the work of the ECS, so the cardiologist can make the final adjustment of its functions and parameters.
• After six months and a year - the doctor assesses the correctness of the selected settings and how much the patient's condition has improved.

Scheduled inspections should be carried out at least once a year. Also, as the service life of the ECS ends, visits to the doctor become more frequent as the device battery begins to discharge and painful symptoms may occur.

Assessment of the state of the artificial pacemaker begins with a patient survey by a cardiologist. The doctor asks about the general state of health, the presence of painful symptoms and the development of complications. After that, a series of tests are conducted:

1. Visual inspection of equipment installation site. In 5% of cases, an inflammatory reaction or bedsore develops at the site of implantation. Moreover, the pathological condition can make itself felt in a few months or even years after implantation. During examination of the chest, the doctor draws attention to the presence of such symptoms.

• Discoloration of the skin.
• Thinning tissue.
• Deformation of the postoperative scar.
• Increased temperature of surrounding tissues.
• Discomfort with pressure on the implant.

The cardiologist identifies the first signs of the disorder and prescribes methods for treating / preventing inflammation.

2. Electrocardiography and tests with loads. To check the correct location of the electrodes, the patient must hold the breath and move a little. If there is a pronounced tension and atypical movements in the pectoral muscles, then with increased physical activity a person may experience severe dizziness. A mandatory X-ray examination.
3. To check the EX-use the programmer. It is a special computer that is connected to the programming head of the stimulator. The device reads all the information about the cardiology equipment and the information it collects about the work of the heart. If necessary, the programmer changes the settings EX. Also, an analysis of the additional functions of the device.
4. To test the performance of the EX-assigned magnetic test. A cardiologist brings a special magnet to the implant. When interacting with it, the device should switch to the operating mode with a frequency of 99 per minute. If the results are lower, this indicates a low battery.

The cardiologist, cardiovascular surgeon, or arrhythmologist is responsible for checking and setting up the pacemaker. The procedure is carried out in a clinic or in a hospital where an ECS was installed.

Pacemaker electrodes

Today, electrodes in medical devices that support heart rate are of two types:

• Active fixation - setting the electrode in the cavity of the heart, that is, in the chambers or ventricles. For fastening special screw hooks are used.
• Passive fixation - the device is connected to the heart by an anchor method, that is, with the help of special antennae at the end of the electrode.

At the tips, the electrodes have a steroid coating, which reduces the risk of inflammatory processes in the implantation site. This increases the service life of the mechanism, reduces energy consumption and increases the threshold of sensitivity. Special attention is paid to classification by configuration:

• In the bipolar circuit, the cathode and the anode, that is, both poles are located in the distal part of the electrode. Bipolar electrodes are large, but less susceptible to external interference: muscular activity, electromagnetic fields. Their installation is carried out with endocardial implantation EX.
• With a unimodal circuit, the function of the anode is performed by the instrument body, and the cathode is the electrode tip.

If an EKS is installed to treat blockages, the electrodes are placed in the right atrium and ventricle. Special attention is paid to reliable mechanical fixation. Most often, atrial electrodes are fixed in the interatrial septum, and ventricular - in the upper part of the right ventricle. In 3% of cases, the dislocation of the electrode is noted, that is, its displacement from the installation site. This causes a number of pathological symptoms and requires a replacement procedure.

During scheduled inspections, the doctor assesses the condition of the electrodes, as there is a risk of developing an infectious complication, endocarditis. Microbial infection of intraarticular structures is manifested by fever and prolonged bacteremia. Infectious lesion of electrodes is extremely rare. For treatment, complete removal of the EX with subsequent antibacterial therapy is indicated.

Pacemaker Screens

All modern models of EKS have protective screens from exposure to electromagnetic and magnetic radiation. The main method of shielding the device is its protective case, which is made of metals that are inert to the body, usually titanium.

Due to this, the pacemaker is not rejected after implantation and is not sensitive to the effects of metal frames or power lines. At the same time, potential detectors may be metal detectors used at high security sites and at airports. They must be bypassed by showing the passport EX and the patient card.

Technique of the pacemaker setup

The installation of a pacemaker takes place under local anesthesia and takes about 2-3 hours. The technique of the operation depends on the type of implantable device. The single-chamber ones are the fastest installed, the situation with three and four-chamber models is much more complicated and longer.

The operation consists of the following stages:

• Preparation of the surgical field and anesthesia. The chest area is treated with an antiseptic and anesthetic is administered. As soon as the medicine has taken effect, the implantation procedure begins. The device is sewn on the right or left under the clavicle.
• The introduction of electrodes. The surgeon dissects the tissue and subcutaneous tissue, inserts the electrodes through the subclavian vein into the desired chambers of the heart. All manipulations are performed under radiological control.
• Installing the case of the EX. If the electrodes are installed correctly, the cardiologist proceeds to fix the device itself under the pectoral muscle or in the fiber. Right-handed machine put on the left and left-handed right.
• Programming apparatus, suturing and wound treatment. At this stage, the required frequency of stimulation of impulses is established and sutures are applied.

At the expiration of the life of the EKS, it can be made to reinstall both the case itself and the entire electrostimulating system.

Heart pacemaker surgery

Sewing in an artificial heart rate driver is minimally invasive. The operation is performed under local anesthesia, in a special operating room with an X-ray machine. The doctor pierces the subclavian vein and inserts an introducer with an electrode into it. All movements are carried out under the control of X-rays.

The most difficult step is to install and fix the electrodes in the atrium or ventricle for good contact. The surgeon measures the threshold of excitability several times to select the optimal, highly sensitive electrode localization.

At the next stage, the instrument housing is stitched. EX-set under the skin or in a special pocket under the muscle. Then the doctor sews up the wound and again tests the device. As a rule, the duration of the operation is about 2 hours. In rare cases, when using special methods of implantation surgery may take up to 3-4 hours.

The duration of the operation to install a pacemaker

The installation time of an artificial heart rate driver depends on its type. On average, the duration of the operation is 2-3 hours.

For implantation of a single-chamber EX you need about 30 minutes, plus the time for wound closure. Two-chamber devices are installed within an hour, and three and four-chamber - up to 3-4 hours. Surgical intervention is performed under local anesthesia, so the patient does not experience discomfort.

Where to put a pacemaker?

The installation of a medical device for maintaining heart rate is performed under the clavicle. The choice of this area is explained by the fact that the wires coming out of the ECS through the subclavian vein are placed in the heart.

Electrodes can be inserted through a vein at the base of the neck or on the shoulder. The surgeon inserts the electrode into the desired chamber, then checks its position using an x-ray machine and fixes it.

In the next step, the installed wire is connected to the EX-body and the device is sewn into the prepared space between the skin and the pectoral muscle. At the final stage, a test of heart stimulation and wound closure is carried out.

Contraindications to the procedure

The lack of substantiated indications for the implantation of EX-is the main contraindication to the installation of a pacemaker. In medical practice, there are several controversial cases in which the device may be superfluous:

• Atrioventricular block I degree without clinical manifestations.
• Atrioventricular proximal blockade of grade II type I without clinical symptoms.
• Regressive atrioventricular block. May develop due to medications.

In order to minimize the risk of conducting an unreasonable operation, Holter monitoring is prescribed to the patient. A 24-hour heart rate tracking and analysis of the data obtained allow us to make a final conclusion about the need for an artificial pacemaker.

[3], [4], [5]

Contraindications for age

The operation of implantation of a pacemaker has no age contraindications. The device can be implanted at any age, that is, both babies and the elderly. Restrictions arise when there is a high risk of instrument rejection.

Poor survival rate of the EX-is possible with the autoimmune reaction of the body. In this case, our immune system perceives the implant as a foreign body and begins to attack it. Such reactions are found in 2-8% of cases, but more often in elderly patients.

As for the possibility of the development of purulent, infectious and other complications. Their appearance is in no way connected with the age or sex of the patient. Similar effects occur when a weakened immune system or a violation of safety during the installation of the device.

[6]

Contraindications after installation

As well as after any surgical intervention, after the installation of an EKS, the patient will face a number of restrictions. Most of the contraindications are temporary, consider them:

• Excessive exercise.
• Any traumatic activities.
• Magnetic resonance tomography.
• Long stay near metal detectors and power lines.
• Passing shockwave lithotripsy without correcting the pacemaker settings.
• Electrocoagulation of tissues during operations without changing the mode of stimulation EX.
• Carrying a mobile phone close to your heart.

Compliance with the above recommendations allows you to avoid premature failure of the device or the development of complications due to incorrect operation of the implant.

[7], [8], [9], [10], [11]

Consequences after the procedure

Consequences and treatment after installing a pacemaker reader here

[12],

Complications after the procedure

Implantation of an artificial heart rhythm driver in certain diseases is the only chance to maintain cardiac activity. But in rare cases, installing the EX-ends with serious complications. The main causes of postoperative problems include:

• Asynchronous work of the ventricles.
• The loss of the relationship between contractions and excitations of the heart.
• Lack of coordination between the discharge of blood into the aorta and peripheral resistance.
• The development of arrhythmia.
• Conducting the impulse from the ventricle to the atrium.

Most often, patients are faced with such complications after inserting EX:

1. Hemorrhagic complications. Subcutaneous hemorrhages can turn into serious hematomas. Intense hematoma requires urgent removal. Minimally invasive surgery is performed to remove a blood clot. To prevent further thrombosis, the patient is put a pressure bandage on the postoperative scar.
2. The displacement of the electrodes is one of the most frequent complications of the operation. Problems may occur with puncture of the subclavian vein. Often, patients experience damage to the brachial plexus and puncture of the subclavian artery, pneumothorax, air embolism, hemothorax.
3. Infectious complications develop in 2% of cases and are usually caused by staphylococcus. To prevent infection, the patient is given intravenous antibiotics. If the infectious process has affected the entire body, then removal of the pacing system and complex antibiotic therapy are indicated.
4. Ulceration of the skin over the implant. This is a later complication that develops due to a violation of the technique of the operation. The problem occurs in such cases:

• Formation of a close bed for installing an EX-body.
• The proximity of the device to the surface of the skin.
• Body with sharp edges.
• Slim physique of the patient.

Thinning and redness of the tissues is a sign of a pressure sore, it can also indicate a secondary infection. For treatment, a change in the location of the apparatus or its complete removal is indicated.

5. Venous thrombus - this complication is rare. Possible thrombosis of the subclavian vein or pulmonary thromboembolism. For treatment, anticoagulant therapy is carried out.

In order to minimize the risk of the development of the above postoperative complications, a comprehensive preparation for surgical intervention was shown, as well as monitoring of the results of implantation during the first year.

Pacemaker rejection

Implantable EXs are made of inert material for the human body. This is due to the fact that the immunity perceives the embedded device as a threat to health and begins to attack it. The immune system produces specific autoantibodies against foreign bodies, which leads to the rejection of a pacemaker.

To prevent the process of rejection, the patient is prepared for implantation and within 10-14 days is observed in the hospital after surgery. Also, the patient is prescribed medications that reduce the risk of adverse treatment outcome.

[13], [14], [15], [16], [17]

Cardiac arrest with pacemaker

With an increased risk of sudden cardiac arrest or a serious violation of its rhythm, patients are put on a pacemaker with a defibrillator function. The device is implanted with tachycardia or problems with fibrillation. In this case, the device controls the heart and, if necessary, stimulates it by sending electrical charges.

An artificial pacemaker is a guarantee that a person will not die from a cardiac arrest or the consequences of a malfunctioning organ. Cardiac arrest with ECS is possible in the event that the device fails or life-threatening complications occur. That is, the stimulator itself does not prolong life, but improves its quality.

[18], [19], [20], [21], [22], [23], [24], [25]

Care after the procedure

After the operation to install the patient, the patient goes through rehabilitation chickens, which is aimed at restoring the normal functioning of the heart muscle and the whole body. Restoration begins from the moment of leaving the intensive care unit, where all those who have been implanted a pacemaker are placed.

• The patient spends the first 24 hours in the supine position, and the arm on the side of which the device has been sewn is immobilized. Painkillers and a number of other medicines are prescribed.
• After a day or two, it is allowed to get up and gradually walk, the hand is still immobilized. If necessary, an anesthetic is introduced and the bandage over the wound is changed.
• On the 4-5 day, the work of the ECS is checked, a complex of tests is also assigned to assess the state of the body.
• After 1-2 weeks, the patient is discharged home for further rehabilitation. Before discharge, the bandage and stitches are removed. Postoperative scar can not be wetted for 3-5 days. If the wound does not heal well, antibiotics and anti-inflammatory drugs are prescribed.

During discharge, the cardiologist talks to the patient, gives a passport to the installed device, talks about the nuances of his work and the period of service. Upon returning home, you must maintain physical activity, but do not overload the body. Also recommended balanced, rich in vitamins nutrition.

Rehabilitation after a pacemaker

After implantation of an artificial pacemaker, the patient will have a long rehabilitation period. Recovery takes from 2 to 8 months. Conventionally, this period is divided into several stages:

1. Postoperative care of the wound and monitoring the work of the ECS. The patient spends 7-14 days in the hospital, and the first days in intensive care.
2. 2-4 months after the apparatus has been stitched, a special gymnastics, diet and, if necessary, drug therapy are prescribed.
3. After 6 months there is a complete scarring of the operated area, therefore, restrictions on physical activity are removed.

Also, patients are given recommendations for maintaining health, which apply to all people with heart disease: diet, moderate activity, regular check-ups with a cardiologist.

[26], [27]

Pacemaker life

On average, the work of an artificial pacemaker is designed for 7-10 years of work. The exact service life of the EX-depends on its model, mode of operation, functions used. Before the end of the work, the device gives a specific signal that the cardiologist records during a routine check.

The failed device is changed to a new one with repeated surgical intervention, since recharging the battery is impossible. The battery of the device is discharged gradually and is accompanied by the following symptoms:

• Slow heart rate.
• Dizziness and fainting.
• Respiratory failure and shortness of breath.
• Increased fatigue.

In some cases, the pacemaker fails much earlier than the end of the battery charge. This is possible with the rejection of the EX, infectious and other life-threatening complications.

Pacemaker replacement

The main indication for replacing an artificial heart rate driver is the exhaustion of its battery. But there are also emergency cases requiring the removal of the device:

• Failure of the device.
• Suppuration bed ex.
• Infectious processes near the electrodes or the housing.
• Rejection.

The replacement takes place under local anesthesia. The doctor makes an incision and removes the body of the EX. Then the condition of the electrodes is checked and a new device is connected. After that, the surgeon sews up the wound and sends the patient to the postoperative ward. If there was a replacement of the electrodes, then the patient is placed in intensive care for a day.

The cost of replacing a pacemaker is the same as for its initial installation. In some cases, re-implantation is carried out according to quota.

Reviews

Numerous positive feedbacks on the work of the pacemaker confirm not only the effectiveness, but also the need for this device, especially when other treatment methods are unable to restore the normal functioning of the heart.

Despite the long period of rehabilitation, the risk of complications and a number of restrictions that should be followed throughout life, an EKS allows you to re-feel in your body and enjoy life.

Alternative to pacemaker

To date, methods for replacing the procedure for implanting an artificial heart rate driver have not been developed. In some diseases, instead of an EX-patient, life-long drug therapy may be offered to the patient. But it is necessary to take into account the health risks, since the pills are toxic.

That is, a decent alternative to a pacemaker that would pass clinical trials and was safe for the body does not exist. But despite this, American scientists are engaged in the development of drugs, the effect of which is aimed at simulating heart rate. If the effectiveness of this project is confirmed, in the near future, gene therapy will allow to abandon the surgical insertion of the EX.