Not long ago, the only treatment medical science had for irregular heartbeat conditions was a handful of medicines. Today, a conventional approach would be to begin with medical therapy and, if needed, complement that with implanting a pacemaker or an implantable cardioverter defibrillator ICD.
Both these operations require minor surgery. The device is inserted under the skin of the chest or abdomen, and wires lead to specific sites on the heart.
Using a pacemaker does not cure heart disease. Many people with pacemakers and ICDs still face significant limitations on their activity levels—restrictions that may rise to the level of a disability. In addition, people with these implants must not engage in heavy lifting and avoid some sources of electromagnetic radiation, and those limitations may rule out returning the job held before the pacemaker was implanted.
Most heart disease patients will still be able to perform very light or sedentary work after receiving a pacemaker or ICD implant, despite the restrictions they face. When you have this condition, treatment is important for your health. Keep reading to learn about the different treatment options you have for varicose veins.
But you may not understand how dangerous heart disease is to your overall health. Keep reading to learn why you should take heart disease seriously to save your life. As you get older, strokes and heart attacks become more of a risk. But there are ways for you to decrease your chances of suffering a stroke.
Here are the steps you can take to prevent a stroke. Do you have unsightly varicose veins in your legs? Not only do they give you confidence issues, but they might have you worried that they'll affect your overall health.
Should you be concerned about varicose veins? There are two types of bradycardia : Sinus node dysfunction — This type of bradycardia occurs when the electrical signal from the sinus atrial SA node slows or disappears completely, and the SA node does not produce enough beats. AV block — In this type of bradycardia, not all heartbeats are able to travel from the top chamber to the bottom chamber of the heart.
There are several levels of severity for an AV block. Previous Section Next Section. What to Expect. Before During After. Before the Procedure. You won't be allowed to eat or drink for eight hours prior to the procedure. We will instruct you if you need to stop any medications before the procedure. During the Procedure. Patients will receive some sedation intravenously to help with relaxation during the procedure. Pacemaker Insertion Process Generally, a pacemaker insertion follows this process: Patients will be asked to remove any jewelry or other objects that may interfere with the procedure Patients will be asked to remove clothing and will be given a gown to wear Patients will be asked to empty their bladder prior to the procedure An intravenous IV line will be started in the hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed Patients will be placed in a supine on back position on the procedure table Patients will be connected to an electrocardiogram ECG or EKG monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes.
Vital signs heart rate, blood pressure, breathing rate, and oxygenation level will be monitored during the procedure Large electrode pads will be placed on the front and back of the chest Patients will receive a sedative medication in IV before the procedure to help patients relax. However, patients will likely remain awake during the procedure The pacemaker insertion site will be cleansed with antiseptic soap Sterile towels and a sheet will be placed around this area A local anesthetic will be injected into the skin at the insertion site Once the anesthetic has taken effect, the doctor will make a small incision at the insertion site A sheath, or introducer, is inserted into a blood vessel, usually under the collarbone.
The sheath is a plastic tube through which the pacemaker lead wire will be inserted into the blood vessel and advanced into the heart It will be very important for patients to remain still during the procedure so that the placement will not be disturbed and to prevent damage to the insertion site The lead wire will be inserted through the introducer into the blood vessel.
The doctor will advance the lead wire through the blood vessel into the heart Once the lead wire is inside the heart, it will be tested to verify proper location and that it works. Fluoroscopy, a special type of X-ray that will be displayed on a TV monitor , may be used to assist in testing the location of the leads Once the lead wire has been tested, an incision will be made close to the location of the catheter insertion just under the collarbone. Patients will receive local anesthetic medication before the incision is made The pacemaker generator will be slipped under the skin through the incision after the lead wire is attached to the generator.
Generally, the generator will be placed on the non-dominant side. If patients are right-handed, the device will be placed in the upper left chest.
After the Procedure. Wound Care Change the dressing over the PM incision site daily: Remember to wash your hands before and after changing the dressing Remove the dressing from your incision and look at it carefully in a mirror If you have steri-strips, do not remove them the steri-strips will be removed at your two-week incision check-up Replace the dressing with a clean dressing dressing materials should be provided to you before your discharge Notify the Stanford Cardiac Arrhythmia Service at for the following: Infection - swelling, redness, or warmth around the incision; significant pain when touched; yellowish, greenish, or bloody discharges on your dressing or on the incision; foul smell Bleeding - blood oozing from the incision or PM site has become swollen or enlarged and feels tense bleeding beneath the skin Fever - if you are feeling excessively warm or have chills and your temperature is greater than F Sponge bath only for the first 5 days following the PM implantation.
Showers can be done after the fifth day, unless otherwise instructed by your doctor The incision site can get wet; do not cover the incision with plastic wrap while showering Do not rub directly over the incision site or use a wash cloth, but let the water or soapy water flow Do not submerge your incision site in the tub, pool, hot tub or lake until it is well healed at least 7 days Avoid using deodorants, powders, creams, lotions, etc.
Do not rub while drying. Activity Activity on the side of the pacemaker should be limited for week six weeks recommended for biventricular pacemaker as follows: Do not lift the elbow that is on the side of your pacemaker above the shoulder. Movement of the large shoulder muscle could cause the lead inside of the heart to move out of position. Repositioning of the leads will require another surgical procedure.
Do not participate in any activities that require forceful large arm movements, such as basketball, swimming, golf, and vacuuming Do not lift anything over 10 pounds We recommend walking for at least 30 minutes, five days a week. You may increase your activities slowly and resume your usual level of activity after 6 weeks If you have additional questions about activities and exercise, please discuss them with us. Driving should be discussed on an individual basis with your doctor. Electromagnetic Interference Electromagnetic fields can interfere with the pacemaker's ability to sense an abnormal rhythm.
Some devices and machines are safe to use while other devices are not: Microwave ovens, computers, VCRs, small electrical tools, and garage door openers are all safe to use Avoid devices or areas that have strong electric or magnetic fields such as: leaning over a car engine while it is running, running motorcycle engines, power plants, ham radios, etc.
Cellular phones, MP3 players, and headphones should be held at least 6 inches away from your pacemaker. Hold the phone on the ear opposite your pacemaker and avoid keeping your phone and headphones in a pocket on top of your pacemaker. Avoid resting your head on the chest of a person with a pacemaker while wearing headphones When traveling in the airport, tell security you have a pacemaker and request for a hand search instead of walking through the metal detector.
The metal detector will not harm the pacemaker but it may set off the alarm. Limit scanning with a hand-held metal detector over the device no longer than necessary. Inform your health care provider that you have a pacemaker before they perform any test or procedure using medical or electronic devices. The electrocautery might be misinterpreted by the pacemaker as heart beats and withhold pacing Normal teeth cleaning are safe and require no special instructions.
You cannot have an MRI because of the possible magnetic interference. Identification Carry your pacemaker identification card in your wallet at all times. Follow-Up It is very important that you have your pacemaker checked regularly 4 to 6 weeks after implant and every 6 months thereafter. Need to schedule an appointment? Please call Cardiac Arrhythmia Service at Symptoms - Medical emerygency You should lie down immediately, make sure you are in a safe environment, away from any machines or moving vehicles, and call a friend or family member, or call , if you feel any of the following symptoms: Lightheadedness Fast heart rate palpitations Dizziness Chest pain Shortness of breath Fainting or near fainting syncope Important Phone Numbers: Stanford Arrhythmia Service: - for questions or problems available 24 hours a day, 7 days a week Stanford Device Clinic: - for appointments.
Frequently Asked Questions. What precautions should I take with my artificial pacemaker? Discuss the following in detail with the doctor: Use caution when going through airport security detectors. Can I participate in regular, daily activities with a pacemaker?
Patients with a pacemaker may still be able do the following: Exercise moderately, upon advice from the doctor Drive or travel Return to work Work in the yard or house Participate in sports and other recreational activities Take showers and baths Continue sexual relationships When involved in a physical, recreational, or sporting activity, a person with a pacemaker should avoid receiving a blow to the skin over the pacemaker.
How can I ensure the pacemaker is working properly? The proper method for checking the accuracy of the pacemaker includes the following: Patients should their pulse regularly to make sure the pacemaker is keeping pulse at the targeted rate Check the "pacing lead" the lead which sends information from the heart to the pacemaker with an electrocardiogram ECG at your doctor's office. In addition, patients may participate in a telephonic checkup for the pacemaker on a periodic basis.
The doctor will provide special instructions See the doctor regularly for check-ups Report any unusual symptoms or symptoms like those had prior to the pacemaker insertion to the doctor immediately Always consult your doctor for more information, if needed. What is the pulse? Taking a pulse not only measures the heart rate, but also can indicate: Heart rhythm abnormal rhythm may indicate a heart disorder Strength of the pulse a weak pulse may indicate a fast heart beat in which some beats are too weak to feel, heart failure, or a low volume of blood in the circulatory system.
How do I take an accurate pulse? Play Video. How do I check my pulse? When taking your pulse: Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse Begin counting the pulse when the clock's second hand is on the 12 Count your pulse for 60 seconds or for 15 seconds and then multiply by four to calculate beats per minute When counting, do not watch the clock continuously, but concentrate on the beats of the pulse If unsure about your results, ask another person to count for you If the doctor has ordered you to check your own pulse and you are having difficulty finding it, consult your doctor for additional instruction.
Do mobile phones or other devices interfere with pacemakers? Other devices Most electrical and mechanical devices won't interfere with the pacemaker.
Do pacemakers need to be adjusted periodically? When replacing a pacemaker, are the leads also replaced? When should the pacemaker be replaced? How do I get a pacemaker ID card? Can patients travel with a pacemaker? Will I feel the pacemaker? Our Clinics Cardiac Arrhythmia Service. Advanced Heart Failure Program , Phone:
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