Permanent Pacemakers
Peter Nalos, MD, FACC and FACP
Cardiac pacemakers are designed to be implanted inside the body to regulate the
heart's rhythm and prevent the heart from slowing down. They are divided into
pacemakers which are single chamber in the ventricle only and pacemakers that
are dual chamber that pace and sense in both the atrium and the ventricle. In
patients with chronic atrial fibrillation, it is only necessary to place a
single-chamber pacemaker. In patients that require dual-chamber implantation,
they have a regular rhythm in the upper chamber. Pacemakers are placed in
patients who have bradycardias or have intermittent electrical heart block or
complete heart block. The permanent pacemaker is put in surgically. The patient
is taken into an operating room and receives intravenous sedation and also
receives oxygen. He does not have any food prior to the procedure, and an
incision about 1-1.5 inches is made in the upper chest and a pocket is made
below the skin for the pacemaker battery to be placed. Then with a needle small
wires are introduced into the subclavian vein and threaded down under X-ray
guidance into the chambers of the heart. Once this is performed, the leads are
tested to see if the heartbeat can be regulated appropriately, and a number of
electronic parameters are measured and then the leads are anchored to the
tissue and connected to the pacemaker. At that time, the wound is closed and
the patient will be admitted to the hospital, often for 24 hours for receiving
intravenous antibiotics. The patient's rhythm will be monitored. Following
surgery, the patient will be required to avoid a lot of motion with his arms,
especially raising over the head or repetitive lifting of certain weights until
all of his tissues have healed (approximately three weeks).
Peter Nalos, MD, FACC and FACP
- is Board Certified in Internal Medicine, Subspecialty Board of
Cardiolovascular Diseases. Doctor Nalos is a Fellow of the American College of
Cardiology. Dr. Nalos is certified by and a member of NASPE (North American
Society of Physician Electrophysiologists).
|
Tetsuo Ishimori, MD
