Bradycardia: What is the risk of surgery to install a cardiac pacemaker?

Bradycardia: What is the risk of surgery to install a cardiac pacemaker?  A cardiac pacemaker is an electronic therapy instrument implanted in the body. The pulse generator emits electrical pulses powered by the battery.

Through the conduction of the electrode wires, it stimulates the myocardium contacted by the electrodes, excites and contracts the heart, thereby achieving treatment The purpose of cardiac dysfunction due to certain arrhythmias.

It is generally used for slow heartbeat, bradycardia, atrioventricular block, etc. that cause patients with fatigue, amaurosis, syncope, or risk of sudden death. Rarely, it is used for patients with tachycardia and bradycardia.

According to the pacing heart chamber and the number, it is divided into:

(1) Single-chamber pacemakers-atrial pacing (AAI), ventricular pacing (VVI);

(2) Dual-chamber pacemaker-atrial and ventricular sequential pacing (DDD);

(3) Three-chamber pacemaker-single room and double room pacing, double atrium and single ventricle pacing;

(4) Four-chamber pacemaker-double room, double room pacing. At present, more than 99% of pacemakers in clinical use are single-chamber or dual-chamber pacemakers.

According to the application time, it can be divided into temporary pacing and permanent internal pacing. Under normal circumstances, the longest indwelling time of temporary pacing is 4 weeks, which is mainly used for temporarily reversible slow heartbeat. For permanent internal pacing, the pacemaker is implanted in the body, most of which can work continuously in the body for 8-12 years.

The purpose of implanting a pacemaker is to save the patient’s life, restore the patient’s ability to work, and improve the quality of life. The current main indications can be simply summarized as severe heart diseases such as slow heartbeat, weak heart contraction, and cardiac arrest. According to the patient’s condition, choose the right pacemaker.

Temporary cardiac pacing includes percutaneous pacing, transesophageal pacing, transthoracic puncture pacing, thoracotomy epicardial pacing, and transvenous pacing. The femoral vein, subclavian vein, or internal jugular vein puncture is usually used to insert temporary pacing lead wires.

The vast majority of permanent cardiac pacing currently uses endocardial lead wires. First, insert the lead wire from the vein under the clavicle of the upper chest. Under X-ray fluoroscopy, insert it into the predetermined cardiac pacing position, fix and test. Then, a pacemaker connected to the lead wires is embedded in the chest, the skin is sutured, and the operation can be completed.

The heart is known as the engine of the human body, and the heartbeat is the source of power for the body’s blood circulation. Many patients are worried about installing a pacemaker. In fact, it is safe to install a pacemaker.

Common misunderstandings of pacemaker implant surgery:

(1) What is the risk of surgery to install a pacemaker?

Pacemaker installation surgery is generally a minor operation for experienced doctors. Most of them use local anesthesia. The patient is awake and local anesthetics are administered. There is no need to open the chest, just an incision in the chest for about 3~ A small 4 cm incision, the operation time is 15-30 minutes.

The most common risk is a small number of patients with postoperative wound infection and electrode dislocation, but the overall incidence is low, only about 1%.

(2) Can’t use electronic products after installing pacemaker?

Most electronic products have no effect on pacemakers, including mobile phones, computers, and household appliances, which can be used with confidence. Passing through the anti-theft doors of shopping malls, supermarkets, libraries, banks, and airport security systems at a normal speed will not interfere with the work of the pacemaker.

(3) Can’t move after the pacemaker is installed?

Within 2 to 3 months after the pacemaker is implanted, the ipsilateral limb can hold the bowl and write, and after 2 to 3 months, dance and gymnastics can be performed. However, it is not recommended to use the upper limb for years of repeated and frequent strenuous exercises (such as splitting). Material and playing badminton) to prevent the pacemaker electrode from wearing out.

Finally, experts reminded that in the early stage of pacemaker installation, the pacing threshold is often unstable and needs to be adjusted in time. Therefore, regular follow-ups should be made according to the doctor’s advice. Most of the pacemaker working status tests are required in the first and third months after surgery. . Postoperative patients should maintain a good mood and ensure a regular life and work and rest system. Avoid contact with strong magnetic fields, such as television transmission towers, high-voltage power distribution facilities, radar antennas, large motors and other equipment.

(source:internet, reference only)

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