Permanent Pacemaker Implantation: PART — 2

Types of pacemakers:

• Single chamber pacemaker. This type usually carries electrical impulses to the right ventricle of your heart.
• Dual chamber pacemaker. This type carries electrical impulses to the right ventricle and the right atrium of your heart to help control the timing of contractions between the two chambers.
• Biventricular pacemaker. Biventricular pacing also called cardiac resynchronization therapy, is for people who have heart failure and heartbeat problems. This type of pacemaker stimulates both of the lower heart chambers (the right and left ventricles) to make the heart beat more efficiently.

Pacemakers work only when needed. If your heartbeat is too slow (bradycardia), the pacemaker sends electrical signals to your heart to correct the beat. Some newer pacemakers also have sensors that detect body motion or breathing rate and signal the devices to increase heart rate during exercise, as needed.

A pacemaker has two parts:

• Pulse generator. This small metal container houses a battery and the electrical circuitry that controls the rate of electrical pulses sent to the heart.
• Leads (electrodes). A lead is an insulated wire that connects to the pulse generator at one end and is placed in one of the heart chambers at the other end. Leads are most often placed through large veins in the chest that lead directly to the heart. An electrode at the tip of the lead contacts the heart wall. The leads send electrical impulses to the heart. It also senses the heart’s electrical activity and sends that information back to the pulse generator. Pacing leads are placed in the atrium (superior atrium), ventricle (inferior atrium), or both, depending on the medical condition.

Symptom:

• Chest pain
• Tachycardia
• Bradycardia
• Irregular heartbeat
• Heart palpitations
• Shortness of breath,
• dizziness or lightheadedness, nausea or fainting.
• Unexplained confusion.
• Swelling in your ankles, legs, and abdomen.
• Needing to urinate multiple times at night.

Risks:

• Infection near the site in the heart where the device is implanted
• Swelling, bruising, or bleeding at the pacemaker site, especially if you take blood thinners
• Blood clots near the pacemaker site
• Damage to blood vessels or nerves near the pacemaker
• Pneumothorax
• Blood in the space between the lung and chest wall
• Movement (shifting) of the device or leads, which could lead to cardiac perforation

Accounting for complete experience and practice, Dr. Aritra Konar is a Consultant Interventional Cardiologist at Apollo Gleneagles Hospital, Kolkata. He has been deemed one of the best cardiologists and heart surgeons in Kolkata for his expertise lies in Coronary (femoral & radial routes) angiography, Coronary angioplasty (including primary angioplasty), Peripheral angiography and angioplasty, Permanent pacemaker, ICD, CRT implantation, BMV, BPV, Right heart catheterization and so on, in procedural skills. His guidance is trusted and so are his skills.