Bhubaneswar: Dr Milan Kumar Ghadei, consultant cardiologist & cardiac electro physiologist at Sum Ultimate Medicare Hospital, Bhubaneswar, stated that the pacemaker, a small device that’s placed under the skin in your chest to help control heartbeat, is very useful if the patient’s heart’s natural pacemaker is not fast enough, or because there is a block in the heart’s electrical conduction system and also in some cases of heart failure associated with electrical abnormality of heart.
Ghadei explained that pacemaker can do two functions — pulse generator and leads (electrodes). Pulse generator is a small metal container that houses a battery and the electrical circuitry that regulates the rate of electrical pulses sent to your heart.
While leads (electrodes) is one to three flexible, insulated wires each placed in a chamber, or chambers, of your heart and deliver the electrical pulses to adjust your heart rate.
According to the doctor, there are six types of pacemakers— single chamber pacemaker, sual chamber pacemaker, implantable cardioverter defibrillator (ICD), biventricular pacemaker, physiological pacing (his/left bundle pacing) and lead less pacemaker.
Single chamber pacemaker usually carries electrical impulses to the right ventricle of your heart. Dual chamber pacemaker carries electrical impulses to the right ventricle and the right atrium of your heart to help control the timing of contractions between the two chambers.
Implantable cardioverter defibrillator (ICD) carries electrical impulse/shock to heart to control fast heart beat and prevent sudden cardiac death. Biventricular pacemaker also called cardiac resynchronization therapy (CRT –P/D), is for people with heart failure with abnormal electrical systems for improvement of abnormal electrical impulse and heart failure.
Physiological pacing (his/left bundle pacing), these are newer pacemakers which carry electrical impulse to both heart muscle and electrical system of heart, in comparison to others which stimulate the heart muscle only.
Lead less pacemaker, these are the devices that are small enough to allow the generator to be placed within the heart, therefore avoiding the need for pacing leads.
Ghadei highlighted that there could be risks during pacemaker implantation like infection where the pacemaker was implanted, swelling, bruising or bleeding at the generator site, especially if you take blood thinners, damage to your blood vessels or nerves near the pacemaker and collapsed lung.
Doctor said there will be special precautions for those having pacemakers like keeping cellphone at least 6 inches (15 centimeters) away from your pacemaker and hold it to the ear opposite the side where your pacemaker was implanted.
Also, certain medical procedures, such as magnetic resonance imaging, cancer radiation treatment, electro cautery to control bleeding during surgery, and shock wave lithotripsy to break up large kidney stones or gallstones could interfere with your pacemaker.
He advised to stand at least two feet (61 centimeters) from welding equipment, high voltage transformers or motor generator systems. He explained that cardiac electro physiologist decides the types of pacemaker that gives benefit to patients; they implant the pacemaker in the body and programme the software of pacemaker.
“After implantation pts should check the pacemaker software, battery status every 3-6 months. If the patient develops difficulty in breathing, swelling of legs, abnormal heart beat, transient black out of vision, loss of consciousness, they should immediately consult a doctor,” he said.
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