Pacemaker surgery could appear daunting, but it is an easily performed procedure and has saved countless lives. Small devices, yes, but they save lives by ensuring heartbeats are in rhythm and optimally functioning. Much more technologically advanced than initially, the costs are much more reasonable than you expected. 

In this blog, we’ll discuss the aspects of pacemaker implantation–what it involves, why patients choose for it, steps involved, the cost implications, as well as everything that comes life after it.

What is a Pacemaker?

Let's get rolling from the basics. Basically, it is a small device implanted under your skin to help manage irregular heartbeats. It can be considered the personal timekeeper of your heart. If your heart beats too slowly (bradycardia) or skips beats, a pacemaker sends electrical signals to keep it in rhythm. You might wonder, "How does a pacemaker work?" The device consists of two main components: the generator and the leads. The generator produces electrical impulses, and thin wires, called leads, carry these impulses to your heart muscles. Pacemakers can be life-changing for those with conditions like heart block, atrial fibrillation, or even just an aging heart that needs a little extra help. So, if your doctor suggests one, it’s worth considering.

These devices are designed to correct rhythm issues in the heart. Some people have hearts that beat too slowly, while others may have an irregular rhythm that interferes with normal circulation. Whatever it is, pacemakers are programmed to monitor your heart and supply electrical signals only when needed. As a result, the heart maintains a steady beat and operates in an efficient manner. 

pacemaker

Types of Pacemakers

Not all pacemakers are the same, and that’s a good thing because not all heart conditions are the same either. Here’s a quick breakdown:

Single-Chamber Pacemakers

These have one lead connected to a single chamber of the heart, usually the right atrium or ventricle. They are typically used for patients with simpler heart rhythm problems.

Dual-Chamber Pacemakers

These use two leads to control both the atrium and ventricle, providing a more natural heart rhythm. They’re especially helpful for conditions like heart block.

Biventricular Pacemakers

Also known as cardiac resynchronization therapy (CRT) devices, these are used for heart failure patients to improve the efficiency of the heart’s pumping.

Temporary Pacemakers

These are used in emergencies or short-term scenarios, like during recovery from surgery. Think of them as a temporary fix. Temporary pacemakers are often external and are used to stabilize a patient until a permanent solution can be implemented.

Permanent Pacemakers

These are implanted long-term to address chronic heart issues. They’re the most common type. Permanent pacemakers are designed to last for years and require minimal maintenance apart from routine check-ups.

Still curious? Some specific types include epicardial pacemakers that are placed directly onto the heart's surface, and external pacemakers that are worn outside the body. These highly specialized pacemakers are used in very specific medical situations where many people would not be candidates for the typical approaches.

Why is Pacemaker Implantation Needed?

So, who actually needs a pacemaker? If you’ve been experiencing dizziness, fainting spells, fatigue, or shortness of breath, these could be signs of a heart rhythm issue. Common conditions that require pacemaker implantation include:

  • Atrial Fibrillation: Irregular and fast heartbeats.
  • Bradycardia: A slower-than-normal heartbeat.
  • Heart Block: When electrical signals are delayed or blocked between the heart’s chambers.

It’s worth noting that pacemakers are not just for older adults. Younger people with congenital heart defects or other conditions can also benefit from these devices. Your doctor will evaluate your symptoms, conduct diagnostic tests like an electrocardiogram (ECG), and determine whether a pacemaker is the right choice for you.

Understanding Pacemaker Surgery 

The idea of surgery can be nerve-wracking, but knowing what to expect can help ease your mind. Pacemaker implantation is a time-efficient and simple procedure that takes about one to two hours. Here’s how it works step-by-step:

  • Preparation: You’ll likely be awake during the surgery, but don’t worry—local anaesthesia will numb the area. Some people also receive a mild sedative to help them relax.
  • Incision: A small incision is made just near your collarbone, so the surgeon makes an effort not to leave too far a scarring.
  • Lead Placement: The surgeon threads the lead through a vein and into your heart while taking X-rays as guidance. It's a very crucial step to ensure that leads will be positioned accurately.
  • Generator Placement: The small generator is implanted under your skin just below your collarbone; it's the size of a matchbox and won't be subtle when it heals. 
  • Testing: The device is tested to ensure it’s working properly. Adjustments can be made at this stage to fine-tune the settings.
  • Closing the Incision: The incision is stitched up, and you’re done!

Recovery is usually quick. Most patients go home within 24 hours, and you’ll receive instructions on caring for the incision and avoiding strenuous activities. You might experience some mild discomfort at the incision site, but this typically subsides within a few days.

Life After Pacemaker Insertion Surgery 

After getting a pacemaker, many people report feeling more energetic and less fatigued. You’ll likely have regular follow-ups to ensure the device is functioning correctly. With modern advancements, pacemakers nowadays have additional convenient features such as remote setting adjustment and sharing of detailed data with one's doctors. Others are capable of monitoring activity levels and adjusting heart rates according to them, therefore, they can be rather efficient. It is also worth mentioning that a pacemaker generally allows most people to return to their normal activities in a few short days. 

Dos and Don'ts After Pacemaker Surgery

Pacemaker surgery doesn't mark an end to life, but patients will have some precautions to bear in mind:

  • Physical Activity: Heavy lifting and extremely strenuous efforts must strictly be avoided for six weeks. You can start slow and gradually return to a regular routine once your doctor gives the green light.
  • Daily Restrictions: Do not place anything, including headphones and mobile phones, on your chest, as it may interfere with the device. While simple, this minor adjustment is a significant one.
  • Diet: An ideal approach is to maintain a diet rich in fruits, vegetables, whole-grain foods, and lean proteins. Lower amounts of saturated fat and salt in the diet are also effective in ensuring the normal functioning of the heart. 
  • Lifestyle Modification: Develop practices to eliminate such habits as smoking and excessive alcohol consumption, which put undue stress on the heart. The key is to maintain a balanced lifestyle and follow your doctor’s advice. Over time, you’ll adapt to life with a pacemaker seamlessly.

The Risks: What Could Go Wrong?

Like any surgery, pacemaker implantation comes with risks, but they’re relatively rare: 

  • Infection: This can occur at the incision site but is treatable with antibiotics. Following post-surgery care instructions minimizes this risk.
  • Lead Dislodgement: Rarely, the leads may move out of place, requiring adjustment. Your doctor will closely monitor this during follow-ups.
  • Allergic Reaction: Some people may react to the materials or medications used during the procedure. These reactions are usually mild and manageable.
  • Heart Side Effects: In extremely rare cases, there could be complications involving the heart itself, such as damage to the blood vessels or heart tissue.

Your doctor will discuss these risks with you beforehand and take every precaution to minimize them. 

Costs of Pacemaker Surgery in India

Implantations in India can be pretty cheap or very expensive based on the type of pacemaker being implanted, the hospital, and the geographical region. A general summary is as follows:

  • Temporary Pacemaker Cost: It costs between INR 60,000 and 80,000.
  • Permanent Pacemaker Cost: It costs between INR 1,20,000 and 2,50,000.
  • Biventricular Pacemaker Cost: It costs between INR 3,00,000 and 4,50,000.

Not only should you know that those wide-cost ranges often encompass the device, hospital stay, and procedure fees, but many hospitals in India have also formed varying and affordable packages whereby insurance covers much more than does out-of-pocket expenses. 

Dr. Manjinder Sandhu for a Healthy Heart

Pacemaker implantation is among the most common and effective treatments for the management of heart rhythm disorders. Although the surgery might sound intimidating, it is pretty straightforward and recovery is quite quick with considerable improvement of life. Be it for yourselves or a loved one, being aware of what to expect will help you wisely make the right decisions. If you have been recommended pacemaker implantation therapy or need consultation for your heart health, book your appointment with Dr. Manjinder Sandhu, providing world-class treatment in India. Consult Dr. Manjinder Sandhu today!

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Max Hospital, B Block, Sushant Lok 1, Near Huda City Centre MF Husain Marg Near Huda City Centre, Sector 43, Gurugram, Haryana 122001

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Max Smart Super Speciality Hospital, Press Enclave Marg, Saket District Centre, Saket, New Delhi, Delhi 110017

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