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25/Apr/2022

The topic for discussion today is tips for diabetes patients’ diet And exercising. And we’re extremely honored to have you with us Dr. Aparna Jaswal leading senior consultant interventional Best Cardiologist in Delhi at Fortis escorts hospital daily. Thank you so much, mam. Once again for accepting our invitation to address this cause. And now I would like to hand out the session to you to guide us further around tips for diabetes patients’ diet And exercising

Hello to you today. I wish to share some tips on Diabetes Care. I am sure all of you who are diabetics are already engaged with a good doctor, but these tips are just to enhance your life and to make sure that your diabetes steak under control. The most important element of good diabetic control is your diet and the second most important is exercise. So if you Implement these two, there is a good chance that you will be taking good care of yourself and keeping your blood sugar by control diet.

It’s important to understand that you must control your carbohydrate intake. You must limit your sugar intake, a good balanced. Diet is a diet that is full of fresh fruits, vegetable nuts, and a limited intake of refined sugars, and comp and oils.

Exercise extreme importance should be given to exercise and that should be consistent and daily. You must remember to take out at least 30 minutes for yourself and go out and exercise daily for 30 minutes and you will realize yourself. If you do these two simple steps your diabetes will be much better controlled than it was in the past.

 


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17/Nov/2021

Hello, everyone. Welcome back to yet another session with Dr. Aparna Jaswal, who is director cardiologist and electrophysiologist at Fortis Escorts Heart Institute Okhla. So we have taken some questions for her which are very common questions that have been asked by many people. So you can also shoot questions at the comment section, we will try our best to answer those questions. So with this, I would like to invite Dr. Aparna Jaswal Best Cardiologist Doctor In Delhi in as well to start this session.

Hello to you all, and I think at the outset, I’d like to thank all of you who are attending this with us. The session today that we have planned is to speak on pacemakers. pacemaker pacemakers. implantation is a fairly common problem that we encounter and we implant in our hospitals. We at Fortis Escorts Heart Institute Okhla do a significantly large number of implants. So we thought that we would choose this point that we would take this on and describe what a pacemaker is, and how do we do that, and take some questions from the audience. So just to begin and give you an insight into what is the pacemaker. So, you know, in common terms, I tell my patients that you can think the 210 rupee coins are clubbed together. And this is exactly what a pacemaker looks like. So, you can see, this is a pacemaker from one of the industry makers and this thin little device is implanted under the collarbone, normally it is implanted under the left collarbone.

Read Also: Empowering Women in The Fight Against Heart Disease by Dr. Aparna Jaswal

So, this is what the pacemaker is made above, you can see it has a metallic box, and it has a header and they are hermetically sealed, what does it mean? It cannot be separated, they are both together. Before we go into the question-answer section, I would like to let you know patients often ask us if this is a battery is this a battery-operated device to which we say yes, this is a battery-operated device. These batteries are very robust. The batteries of these pacemakers can last anywhere between nine to 14 years, which is very good, depending upon your usage depending upon the model that we choose. So these are very robust batteries. But one thing which I want to let you know is that when a battery is a near expiry, we which we come to know by checking the pacemaker in the pacemaker clinic. Whenever we change the pacemaker for the battery, we remove the complete pacemaker and give a new pulse generator. So it is also called a pulse generator. So the same thing remains for all cardiac implantable electronic devices, be it a defibrillator, be it a CRT, be it a pacemaker, you don’t remove the battery and put a new battery, you put you remove the entire device and you give a new device.

Best Cardiologist in janakpuri, Pacemaker Specialist in Janakpuri

This pacemaker is connected to the heart with the help of certain leads. So this is for the for your knowledge I want to share. This is what a lead looks like. So what we do as electrophysiologists, we implant these devices, we implant these devices under this collarbone, we take a puncture, and this lead first enters and goes inside that heart, we position it where we want to position and subsequently, we connect the other end of the lead to the device, we connect it to the device, and then this device is positioned under the collarbone and we make a little pocket and we stitch the pocket up and the patient is fine in the next few days. So this is what I wanted to describe as to what is a pacemaker and what is a lead. We also have special pacemakers today, which could be leadless they do not have leads and they are like a capsule. But for the sake of discussion for today, we have kept the regular pacemakers, which could be single or dual. So we’ll go forward taking the questions and then one by one I will want to answer them.

When will someone get to know that he or she needs to consult the Best Cardiologist Doctor In Delhi? With pacemaker,

So basically, then does one need to seek a medical opinion for a pacemaker? Normally, for all of us, our heartbeats, the beating is 60 to 100 times a minute, when we’re sleeping, it is low, when we are awake, it is high. However, it should remain between 60 to 100 times a minute, for some people, it could be out of this range, but largely it is around this range. So when your pulse rate becomes slow, less than 60 means it could be 50, it could be 40, you could have some symptoms, you could feel dizziness, you could feel lightheadedness, you could feel fatigued, you could feel shortness of breath, you may sometimes feel even palpitations, and the most dramatic sometimes people faint. So, when when you experience any of these symptoms, you must contact the Best Cardiologist In Delhi and your doctor will get an ECG done or may get a Holter done, which is a 24 hour ECG recording subsequent to which we decide whether you need a pacemaker.

What Are The Symptoms of Needing A Pacemaker?

Yes, so as I just mentioned, if you have recorded a pulse, which is low, and along with that you have felt dizzy, you have felt near fainting, you have felt lightheaded, you have felt suffocation, you have fatigue, you are unable to do activities of daily living, you don’t feel like walking around. And if you have fainted. These are some of the signs that you may need a pacemaker.

Best Cardiologit in Okhla, Top Pacemaker Speialist in Okhla Dr Aparna Jaswal

Many People Think That Getting A Pacemaker is A Major Surgery.

We would like you to enlighten us on this if you can tell that the house is not there as well. Yeah, so implantation of a pacemaker, we say is a procedure. We don’t call it to be a surgery. pacemaker implantation is done under local anesthesia, we give local anesthesia here as a result, the patient and us as doctors keep chatting with each other, it gives a lot of comfort to the patient to know that his doctor is there, and his doctor is communicating at that point in time. After we give local anesthesia, we take the punctures, meaning I just showed you, we take them into the way and from the vein, we place these leads, after we placed these leads into the position of the heart that we want to go in, we subsequently position the pacemaker to this lead and connect it to the pacemaker and then position this pacemaker under the collarbone by making it pocket. So this is all done under local anesthesia while the patient is awake. It is not we don’t call it surgery, we call it a procedure simply because it is a fairly simple procedure. It lasts for about 45 minutes to an hour, the patient is in the ICU for one day and subsequently comes to the room and is discharged from the hospital within 48 hours. For any heart, emergency call us:+91 9818797594 and fix your appointment with the Best Cardiologist Doctor In Delhi Dr. Aparna Jaswal Director Cardiologist And Electrophysiologist at Fortis, Okhla.

To be continued on the next article…


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29/Apr/2021

Q: Best cardiologist in Delhi Advice:What Kind of Exercise He Can Do After A Pacemaker Implant?

Ans: You can do all kinds of exercises, what you should not do largely is either picking up very heavyweight or circular motion of your shoulders. The pacemaker has very delicate leads with them soft lead if gets damaged we need to change it. So if you want to protect your pacemaker and the system the exercise which you should not do is the circular motion of the shoulder or lifting very heavyweights. Outside of this, you can do all kinds of exercises that you may desire.

Q: Can I Drive if I Have A Pacemaker?

Ans: Yes. So if you can have a pacemaker implanted or any cardiac device, typically we’d say that you must wait for the local site, which is about two to three weeks subsequent to that you are allowed to drive. However, if you have a device like a defibrillator, you just put in people with a feeling right? In that situation, you must talk to  Best Cardiologist in Delhi, when can you go back for a drive, it is best advisable that you wait for three to six months before you go back to driving. If you have a Heart Pacemaker, you just need to wait for about three weeks.

Q: Do I Need To Tell My Dentist or Doctor That I Have A Medical Device Implanted?

 

Ans: Yes,you need to tell your dentist or doctor that you have been implanted with a medical device if you go for a dental procedure at times.

 

Q: What Should I Do If I Hear A Beeping Sound Coming From My Heart Device?

 

Ans: So these devices are very intelligent, robust devices. They are fed in data and they are taught what to do in strenuous situations, such as if the simplest support is if you are in a far-flung area. And especially in the times of COVID, you are unable to visit and you hear a beep from your pacemaker. It may be telling you on its own that the battery is depleted. In cardiac devices which are beyond the pacemaker, we feed the device much more data to give you an audible alarm, which sounds as if they were an ambulance running and it may be a good idea. So you should know that if I listen to a beep it is telling me something that I need to be careful about.

 

Q: Can I Use stairs for Fourth or Fifth Floor Daily If I have a Pacemaker and ICD?

 

Ans: Pacemaker under no circumstances say that is making you not use a flight of stairs. Remember when you have a pacemaker you will do everything as all other people do. What is most important is to do not do heavy weightlifting or circular movement of your hands. But the question is about a defibrillator if you have a defibrillator implanted. It is given to patients who have who are pumping of the heart, it may not be advisable to fly full flight instead, those of you who are implanted with pacemakers can certainly climb as many flights as you may desire.

 

Note: If you are searching Best Cardiologist in Delhi, so you are in the right place. Call us:-9818797594  or visit the website:- Best Heart Specialist in India

 

Q: Will I Feel The Pacemaker Working?

 

Ans: You will not feel the pacemaker pocket. As I told you these devices are extremely intelligent and robust and trained to work in a specific mannerism. We just like we keep working, they will never let you know, unless they become dysfunctional. If they become dysfunctional, you may find some twitching in your area, or you may find twitching of your abdominal wall in routine activities. For most people, you will never know what your pacemaker is working, you need to go back to the Best Cardiologist in Delhi and visit the pacemaker clinic every four to six months to know if the pacemaker is working appropriately. And the needs of the device.

 

Q: Can I wear a Gold Chain Around My Neck?

 

Best Heart Specialist in Delhi

Ans: Certainly, wear a gold chain because it’s an inert metal, there is no problem. What you should not wear around your neck is anything that is magnetic. So like, what can be like for instance, people wear the Fitbit, don’t wear the Fitbit around your neck. Some people like to hang it in their neck just don’t do that. Because these are all magnetic devices. Just remember that you should keep your device away from the magnetic field for at least 6 inches. If you have a pacemaker on the left, you could use a mobile on the right because it is more than six inches away. You should remember the rule of six inches in all magnetic items, six inches away from your pacemaker.

Is there any precaution that needs to be taken around microwaves and other kitchen appliances? So as I just mentioned, all appliances can be used when you have a pacemaker. The only appliance which you should be cautious about is if you go for physiotherapy and other physical therapy, which is called transcutaneous electrical nerve stimulation, such devices in your homebound devices, you can use most of the electrical appliances at home without anybody.

Q: Can I Go Through The Metal Detectors And Security Checkpoints in the Airport?

Ans: Yes, the metal detector and the security checkpoints most important is to always carry a device card. As soon as you switch the device to the security personnel, they are already duty-bound not to bring the handheld device on your device, your pacemaker, and they will not do it. But for the safer side, you should also inform them that you have been implanted with a device/pacemaker.

Q: Will I be able to use a laptop?

Ans: Yes, all electrical appliances of daily living, there should be no concern. The only thing I mentioned is that do not place your smartphone in your pocket. I’ll tell you that. You can certainly use laptops.

Q: Can I Use Equipment like Hair Dryers and Microwaves? I Have Heard That it Stopped Pacemaker Working. Is it true?

Ans: Okay, so I don’t know how did you get to know this. But if you are in your home, and the electrical grounding of your home is done then you can use all electrical appliances including your hair dryers and microwaves.

Q: What you should understand is if you go for physiotherapy?

Ans: That’s what you should be careful about what kind of physiotherapy your physiotherapist is using. It is then that you need to connect to the Best Heart Specialist in Delhi, outside of that all electrical appliances can be used safely.


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15/Apr/2021

At the very outset, before we start this, I wish to share with you that COVID times are here, we must take utmost care, we must continue to behave in COVID sensitive mannerisms.

We’re right there where we were about a year ago. So please remember that we must remain and continue to have COVID-sensitive behavior. Coming to the subject that we wish to speak on today is how do I take care of a pacemaker? So let me say, why do we choose it, we chose the subject because there seems to be an inherent fear among people, that if they were to have any kind of device in their body, it may hamper their daily living, to be a very simple thing to say that whenever we as medical personnel intervene, it is only to make the life of fellow mankind better.

So when we give any devices, we eat in the heart, beating your knees, beating your shoulder, all of these, these are meant to make your life better. So if you want to speak about pacemakers, and you want to talk about this, because the whole thing to understand is who needs a pacemaker and to be understood first.

Read Also:- 102-Year-Old Woman Successfully Pacemaker Implant

Who Needs A Pacemaker?

I will just try and make you understand that this is the structure of the heart, we have two upper chambers, and we have two lower chambers. For all of us, the electrical impulse comes from the upper chamber, it first goes to the upper chamber, then it goes down with the help of special electrical wires. This is just like you have electrical wires in your home. Similarly, we have electrical wires in our hearts.

More often than not, just so the new homes, the electrical wiring can break, you call the electrician, the electrical wires may switch off for some time, similar in the heart, these electrical wires can become dysfunctional, as we age.

Sometimes, the natural pacemaker of the heart begins to march slowly. And other times the other part of the electrical system may become dysfunctional. So how does the patient present it, the patient presents themselves with weakness, fatigue, or we have very traumatic symptoms, such as having a fall and fainting. So whenever your family if an elderly patient or a middle-aged and about complains of a fainting spell, it needs to be given its due importance, you must seek medical attention, you must do an ECG. Right now we have several diagnostics, which we can do an ECG picks up the rhythm right then sometimes the ECG may not pick it up, then we tell our patients to do a full job. It just has three electrodes, which are stuck to the surface of the chest. And this is a pocket we give to this device in this pocket. It records ECG for 24 hours, 48 hours, maybe one week, maybe two weeks.

That is the utility of an extended loop recorder. Or sometimes we may use an ECG machine as compact as this loop bonuses. What does this do? This records an ECG. How does it do that? It is very simple. All we got to do is have an application on our phone. And before this device in our fingers, just simply hold this little device. You can record your ECG in the comfort of your home, capture the episodes of dizziness, and immediately sent it to your doctor.

It could be a pacemaker It could be a defibrillator, it could be a biometrical, a pacemaker with a defibrillator. And typically these devices look like this. These are bigger than their defibrillators, the pacemakers are much, much smaller, but that’s how they look, the pacemaker and these are the leads, the leads go inside and the pacemaker is inserted. So, that is to tell you about who needs a pacemaker, you have just understood that.

 How is the Pacemaker Implanted

We have to put the pacemaker under the left collarbone, and the lead goes inside the heart. And that is how a pacemaker is implanted. They’re called cardiac devices. They could be a pacemaker or could be a defibrillator. It could be a cardiac resynchronization therapy defibrillator it could be any of these devices.

So you should not be worried about these devices, they are only to make your life better. So to say, once this pacemaker is implanted, during the acute phase, because this is placed under the pocket. But because it is a rock walking, we have just made one, you have to ensure that you take a course of antibiotics, because antibiotics typically last for about five to seven days, you must try not to miss your antibiotics.

Some of us may be allergic to antibiotics or may have some problems, in that scenario you need to go back to your doctor and your doctor will change the antibiotics. The reason we give antibiotics after the implant is we have to be very careful. Whenever we do implants we don’t want any infections to take place. Those patients who are diabetics must ensure that their blood sugars have been under control. Because we don’t want high blood sugar during the procedure, which can at times give rise to infections after the procedure.

Some of us may be allergic to antibiotics or may have some problems like not sure motions, you need to go back to a doctor and your doctor will change the antibiotic. The reason we give antibiotics after the implant is we have to be very careful. Whenever we give implants. We don’t want any infections to take place. Those patients who are diabetics must ensure that their blood sugars have been under control. Because we don’t want high blood sugar during the procedure, which can at times give rise to infections after the procedure.

So the first thing is to remember that you have to take antibiotics, and the antibiotics must continue for at least five to seven days.

Best Heart Specialist Advice

The next thing you have to remember is when you go home off the pacemaker, you must remember that you can lift your arms up to the shoulder level. We always instruct our patients to remember to keep their shoulder moved but a subset of patients are very scared, and they will have pain if they raise their shoulder. By doing so, if you don’t raise your shoulder, it can result in a frozen shoulder.

 

So what we tell our patients, the first five to seven days, raise your shoulder, raise your arms up to shoulder level. Subsequently, you can take your arms above your shoulder. And these are all instructions with which a pacemaker is implanted. We also instruct our patients that they should not touch the pocket for about five to seven days after the pacemaker is implanted. Because it is a wrong move. It is healing. We don’t want any infection in the pocket. You must remember sometimes the pacemakers are given in the summer season, we must ensure the patient is not in a hot and humid climate. We don’t want the patient sweating and the patient’s sweat falling in his own room.

 

By doing so, again, if it is all soiled, it can get infected. So up till now, I have been repeatedly saying in talking about how we need to keep our pacemaker site clean, dry, and should not get infected. We keep calling our patients every 48 hours for repeat dressing. We do these dressings at least three to four times. And we like that our patient goes back to the same doctor who was implanted because by doing so, we are all in close contact and we are able to assess the healing of our patients, and most patients, the local site heals in five to nine days.

 

However, there could be some outliers, wherein the route can take a bit longer. It is important to understand that we should not become impatient. We should continue to Seek an  Appointment With The Best Heart Specialist Doctor and keep going back so that you’re implanting doctors’ confidence and tells you that you don’t need to come back again. Till then keep going back to your doctor.

 

The pacemaker site normally has absorbable sutures. However, when you have any injury route, what you should remember is when you have a specimen on the left, you should avoid sleeping on the left. If you have a pacemaker on the right, avoid sleeping on the right for at least one week to 10 days, because we do not want any blood collection on the pacemaker site.

 

 Along with this, I want to tell you, those of you who are on blood thinners, and need some procedures, like a pacemaker, it’s important to discuss with your doctor that you are on blood thinners, we may want to either stop the blood thinner for a day or two, or we want to do the procedure on the blood thinner depending upon your clinical condition.

 

 At this time, when we’re talking about this, I think it’s important we also discuss at the very end about the vaccine and practitioners because many of you who want to learn about what to do what not to know when you have to get vaccinated, which I will certainly touch about. If you develop a fever at any point in time, after the pacemaker the first one week or 10 days, you must immediately go back to your doctor.

 

But the most important thing is the cell phone whenever you go you should try to keep the cell phone on the contralateral which means if you have a pacemaker on the left, use your mobile phone from the right. And if you have a pacemaker on the right keep the mobile phone on the left this you have to follow for a lifetime.

 

The reason being there are certain magnets that are good not with the pacemaker, these magnets will interfere with your pacemaker.

We all should know the newest generation of the iPhone, which is the iPhone 12.

 

Read Also:-Heart Pacemaker: Purpose, Procedure, and Risks

 

Those of you who are using these into the scanner, to those of patients who are having an iPhone 12 and have cardiac devices, especially like defibrillators must remember to keep their iPhone specifically aware and should not place the iPhone in their upper pocket. You should always keep your cell phone in the pockets of your trousers or in your handbag. Do not place your smartphone in the chest pockets. So if you are having an iPhone 12 because you must be aware that the charging strategy of the iPhone 12 has been altered, they have gone bad, and so forth on the battery charges. As a result, would they have done that the iPhone has a very strong magnetic field inside the iPhone 12? If you will place it in your pocket, there will be some issues.

 

The next thing which comes up is the electrical appliances at home. So what happens when you have a microwave or you have your mixer or you want to use a television remote or you want to use a remote phone.

So you should remember that all the electrical appliances can be used when you have a pacemaker. A word of caution is that when you are traveling or you’re working or you are staying where there are very strong electrical transformers, the ones that you see which are placed in colonies to supply the electricity, you should not be pouring around those electrical transformers because they have magnetic fields and they can interact with a pacemaker.

Best Cardiologist in Delhi Advice

When you’re in airports, whenever you have a pacemaker or cardiac device and you are at the airport, what you should remember is you must always carry your guardian device card in your wallet. Once you show them the card they will do bring that handheld device to the pacemaker pocket.

If a doctor has asked for an MRI, most of the devices that we have are excellent right complexity. Most devices allow you to have an MRI done. You should talk to a doctor who should want an MRI-compatible device. What does it mean? MRI compatible device as the name implies means that if you have a device, you can have the MRI done of your body. If you have a noncompatibleMRI device it is challenging, and it is not yet completely advisable that you can have an MRI done.

Note: If you are searching Cardiologist Doctor in Delhi, so you are in the right place. Call us:-9818797594 or visit the website “Best Cardiologist in Delhi

So other than that, I think I would like you to know that you should know the making industry of the device, you should be knowing whether this MRI compatible or not, you should be in constant touch with your doctor, your device has to be interrogated or checked every three to six months, there are several ways it can be done, you need to come to us in pacemaker clinic. Or you can also have a device checked remotely.

Outside of this, you should remember the battery-operated devices, the battery is embedded in this unit. We change the battery when it finishes, we remove this device, and we want a new device, we do not just remove the battery, we remove this device and we give you a new device. These are battery-operated devices. The typical life of these devices is anywhere between 7 to 14 years, depending upon what device we are using.


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11/Mar/2021

Pacemaker Implant: Making her the oldest woman to have successfully undergone the surgery in the private sector, 102-year-old Maya Devi from Panipat was implanted with a pacemaker by Dr Aparna Jaswal at the Fortis Escorts Heart Institute in the city. The operation has given a new lease of life to the patient, who was brought to the hospital following a stroke and having suddenly collapsed at home.

Dr Aparna Jaswal, (Best Cardiologist in Delhi) senior consultant in the Department of Cardiac Pacing and Electrophysiology at the hospital, who led a team of cardiologist and anaesthetists to perform the surgery in a record time of fewer than 20 minutes last week, said: “In the previous two cases, pacemakers were implanted in 105-year-old men at PGIMER Chandigarh and Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow.”

Dr Aparna Jaswal Describe The pacemakers come in various forms

Pacemaker Implant

we have a single chamber pacemaker, we have a dual-chamber pacemaker, we have the ventricular pacemaker. So, the typical longevity of these pacemakers is roughly around seven to 12 years depending upon which pacemaker we are using. And also depending upon the usage of a pacemaker in an individual patient, so a single chamber pacemaker can last as much as nine to 12 years. So can a dual-chamber pacemaker lasts roughly around nine to 12 years, the by ventricular pacemakers because they have to work more, that current utilization is more their battery drain obviously is a little more so they last roughly around six to nine years, depending upon the current usages of a patient.

Also Read:-Heart Pacemaker: Purpose, Procedure, and Risks

Ms Devi’s great-great-grandson Sazal Dua said: “We are very thankful to the doctors at the institute for saving my great-great-grandmother’s life. We are fortunate to have her in the family and blessed with her presence.




About Us


Additional Director Cardiologist and Electrophysiologist at the Escorts Heart Institute and Research Centre in New Delhi.




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