Pacemaker Surgery in Delhi Archives

29/Nov/2021

Are There Any Complications During Pacemaker Surgery?

Yes. So that’s I think, a very important question that when they will have any procedure done any procedure, it cannot go without saying that there can be some complications. So, whenever we implant the pacemaker surgery, at times at the local site, they can be some collection of blood, they can be an infection in one or 2% of patients in the long term. And in the acute scenario, you may injure the lungs, wherein we may have to insert a tube, they could sometimes be a collection of blood around the heart. So these are complications that are known to occur and can be tackled easily during the implant.

Many People Would Like To Know About The Types of Phases?

So we’ll keep it simple. This is what a normal pacemaker surgery looks like. These pacemakers can either be single-chamber means they have only one wire or they can be dual chambers means they have two wires. As you can see, in this we have two wires we have one wire going to the upper chamber and we have one wire going to the lower chamber in the majority of people. When a pacemaker surgery is needed for poor heart rate, we give them a dual-chamber pacemaker. In a very small minority of patients, we may consider giving Giving them a single chamber pacemaker. At times, we give them devices which are larger, which may need three-wide pacemakers surgery, which are called CRT, or they’re even called CRT DS, those devices are bigger, those devices are bigger and they may be having three wires like this, they are given in special situations. Otherwise, we either give a single chamber which is very seldom, but more often than not, we give two wide pacemakers wherein one wire goes to the upper chamber of the heart, and then in the second wire goes to the lower chamber of the heart.

Can Use MRI Done With Pacemaker Surgery?

Best Heart Specialist in Delhi

Yes, so, can an MRI be done if you have a pacemaker? In earlier years, we did not have MRI-compatible cardiac electronic devices. Today, most of the devices that we have are MRI compatible, or we call them MRI safe. When we say MRI safe or MRI conditional, we mean that when the patient has a device, at the very outset, the patient is told that you have an MRA compatible pacemaker surgery. More often than not patients opt for it because once this is put in, in use to come, if the patient needs an MRI for any reason, it becomes simpler. And if he has an MRI-compatible device, he can go in for an MRI by just informing us or informing his Best Heart Specialist In Delhi wherein we externally make a little change to the pacemaker before and after the MRI. So, these are called MRI safe or MRI conditional pacemakers.

Are There Any Disadvantages Associated With Pacemakers Like Having A Pacemaker?

So, any procedure when you do you have to earn the procedure, you have to be worthy of getting the procedure if you need a procedure, you have to pick up the risks or dangers attached along with which are very few as I just told you, if I may say the disadvantage can only be sometimes you may develop a local infection, you may develop local blood collection, you may sometimes get some injuries along. So these are the complications attached along within the long term. The pacemakers are supposed to heal you, they allow you to perform better in a very small number of patients. When we give the pacemakers in the subset of them, the pumping may come down. So when the Pacemakers are implanted, we always do an echocardiogram before we implant the pacemaker surgery. So we are sure of what kind of a pacemaker and index patient needs.

So How Long Does It Take For Recovery?

Yeah, so as I told you, the procedure is typically done under local anesthesia. We do these procedures under general anesthesia if we have very small children or very elderly patients who are unable to lie on the cap table. Patient after the procedures and systems local anesthesia goes into the ICU, the patient stays in the ICU for one day. Subsequently, the patient is shifted to the room where he stays for a day. And he’s walking the very next day he goes back home walking, he comes back to us every 48 hours for the local sight healing, we do the dressing, it takes about one week for a wound to heal. And after a week the patient is allowed to do all activities. routinely in his house. We allow the patients with pacemakers to resume their driving in about four to six weeks, we allow them to go out for walks in two to three weeks, we allow them to lift their arms in about two weeks. When the pacemaker surgery is when the patient for the pacemaker is discharged, we tell them that you must allow your arm to increase at 90 degrees, this 90 degrees as soon as one day is over. Remember, if you do not move your arms there you result in a frozen shoulder, a frozen shoulder can become a very difficult situation. So you should avoid a frozen shoulder for which you must remember that you must continuously give arm exercises after the first 24 hours to bring it 90 degrees. And after two weeks, raise your arms above. How Do I Take Care Of A Pacemaker?

I Have Got Many People Saying That They Will Not Use Microwaves or Plants Appliances When Implanted. Is it True?

Yeah, I think this is the most pertinent question that once I have a pacemaker implanted in my chest Wall, what is it that I cannot do? The first thing you should remember is when you use a mobile phone, you should use the mobile phone from the other ear. Remember, there are magnetic fields, and you should not want to come with your phone close the pacemaker by six inches. So we always tell our patients to use the mobile phone from the other year, all electrical appliances at home, meaning if it were your mixer, a washing machine, it could be a microwave or television remote, you can use all electrical appliances at home. If you have an MRI-compatible pacemaker, you can go in for an MRI, CT scan, and X-rays and ultrasounds are not a contraindication you can have all these procedures done. One thing that you should remember is if you have any problem and you want to visit a physiotherapist, we tell them that we do not want any electrical stimulation, because a pacemaker may unnecessarily see electrical stimuli. Outside of that, you can do everything you can also walk through when you go to a mall, there are electrical surveillance, you can walk through them do not stand there.

Pacemaker Surgery in Delhi

But what you should remember is those places where there are very huge electrical transformers, we tell our patients not to hang around them very long, which typically we don’t. So by and large, once you have a pacemaker in, you can do most activities of daily living. The Apple Watch, yes, you can use all electronic watches, Apple, I watch, you can do everything. However, one thing we tell does not to keep your phone in your pocket. On the left side, I told you that your devices should be six inches away. So we don’t want you to keep any of your phones, iPhones in the pocket of your shirt, which could potentially interact with your pacemaker.

So alcohol is something that often comes up because of the interest of the patients. But what we need to understand is that alcohol taken in moderation as prescribed 30 to 60 ML is no contraindication for a pacemaker implant. But remember what I said 30 to 60 ML, we must remember that alcohol is to be consumed only in moderation. It is not a contraindication. But when you have a pacemaker implanted, maybe you can wait for about a week or 10 days before you resume having alcohol.

So We Have A Band With Our Questions And We Have Some Questions For You in the Comment Section. So I’ll Read It To You. What is What Hardware is A Pacemaker Need?

Yes. So there is no number, at what heart is a pacemaker surgery need. For some people, we may want to implant a pacemaker at a heart rate of 50, while others may sustain a good quality of life even at a rate of 45. So what is important when we implant a pacemaker is there has to be symptomatic documented low heart rate, meaning the patient says I feel uncomfortable even at 50 I feel dizzy. It’s a reason enough to implant a pacemaker. If a patient is 48 heart rate and says I’m absolutely fine. I can go for my walk, I don’t need I don’t have any problem. We don’t need to implant the pacemaker. So there is no one magical number. But every patient is different and we have to deal differently with each patient.

Any Information Regarding The Microchip?

Yes, so the micro pacemaker, or as it is called a lidless pacemaker. I just mentioned to you that these pacemakers are like capsules, these capsules are inserted from the leg into the heart. So these capsules stay inside the heart without leads. Hence they’re called lead list pacemakers. It is a newer technology, it is catching up very fast. It is very expensive for now, but in a given subset of patients who do not have sites to enter from here, or are on dialysis, or have undergone implants and have infections in the past, we do recommend having a leadless pacemaker is the other option for the prolonged holder. Yes. So I told you that whenever our patients complain of low pulse rate, we have to document it. How do we document that you take an ECG and ECG is 12-second documentation, so it’s diagnostic yield is not very good? So the next thing we depend upon is a halter holder, the 24 hour ECG recording, which is a very good tool to pick up slow heartbeats, yet it may not be sufficient in every patient. For then, we consider doing extended holders it is called extended loop recorders or external loop recorders. They can record your heartbeats for as many as seven days, 14 days, 30 days, and that is stuck to your chest wall. They’re called external loop recorders. However, in some patients, we need longer monitoring. And that’s when the rule roll of these devices comes in. These little devices are called insertable loop recorders, they come mounted on a syringe, and we insert them under the skin. As you can see, they are so slick. As you can see, they are so slick, they are on a syringe, and we give a little nick one-centimeter neck inserted under the skin, right here on the left side, give one suture. Now this little device is called insertable Loop Recorder, it can record your heartbeat for up to three years, it is MRI compatible, and when the patient says that he has an abnormal rhythm or had a fainting spell, the patient comes back to us, we interrogate this device and we get to know immediately what was the cause of the patient’s fainting spell, if it tells us it was because of low heartbeat, we know it needs a pacemaker. If there is some other reason we treat the patient accordingly you have shown us so Is it my surgery or it can be implanted.

So, this is a very simple procedure, it is although done in the wizard it can be done in the OPD setting, it is a small neck, on the skin just on the skin one centimeter, and it is inserted under the skin over the surface over the heart side area. And this picks up the ECG of the heart just like a normal ECG recording and it records up to three years. Hence, it makes it very simple for us to know what our patient has a problem if the patient faints during the insertable Loop Recorder.

Another Question From Our Viewer is If The Heart Rate is High, Then In That Scenario Also Pacemaker is Acquired.

So in a very rare situation for high heartbeats, we may want to give a pacemaker they could be special devices and a pacemaker is given for patients who have a very high heart beating wherein we go inside the heart we may burn the no AV nodal area and subsequently to treat the fast heart beating we have to give a pacemaker. So there are situations

Pacemaker And ICD The Same?

Pacemaker icd

Splendid. So pacemaker and ICD are not the same now that you have asked this question, I will have to show this device to you, which I was using for other reasons. Let me try and show it to you. Okay, so I just showed you the pacemaker. This is what a pacemaker looks like. And if I were to show you what an ICD looks like, this is what an ICD looks like. So surely, the ICD or CRT D is larger than a pacemaker. You can see even from the side, it is larger than a pacemaker. But the implantation procedure of a pacemaker and defibrillator or a CRT is much the same. They are larger, they are more complex devices. Technically, they are more challenging, and the implantation of these devices is also more challenging.

We Have is Life Normal With Pacemaker? Or Will There Be Any Changes in The Life

once you have a pacemaker implanted and your local site is healed, you should forget about the pacemaker and you will lead a life as normal as any other patient any other individual in your vicinity or in your neighborhood. All you need to remember is every six months, you need to revisit your implanting doctor so he can know how your pacemaker surgery is behaving. I told you these are battery-operated devices. These devices need to be continued into interrogation, which can be done either remotely or from our clinic. You can also have these devices monitored remotely from the comfort of your home. Or you must come here into our pacemaker clinics every six months because these batteries last roughly around eight to 12 years.

Thank you so very much now. We have completed the questions from our comment section. For any heart, emergency call us:+91 9818797594 and fix your appointment with the Best Cardiologist Doctor In India Dr. Aparna Jaswal Director Cardiologist And Electrophysiologist at Fortis, Okhla.

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.

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…

What Are The Restrictions After Pacemaker Surgery By Best Heart Specialist in India