Permanent Pacemaker

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What is Pacemaker?
A pacemaker implantation is the insertion of an electronic medical device that sends out small electrical impulses to make the heart beat in a regular rhythm and at a normal speed. It is usually placed in the chest just below the collarbone.


Purpose of a Pacemaker
The primary purpose of a pacemaker is to maintain an adequate heart rate.
Diagnosis before Pacemaker Implantation:

  • Echocardiogram
  • Electrocardiogram
  • Holter Monitoring
  • Stress Test



Pacing methods:

  • Percussive pacing: - Percussive pacing is used usually on the left lower edge of the sternum over the right ventricle, striking to induce a ventricular heartbeat. This is an old procedure which is used as a lifesaving means till an electric pacemaker is inserted in the patient.
  • Transcutaneous pacing: - It is used for the initial stabilization of bradycardias of all types. The procedure is performed by placing two pads in the patient’s chest. The pacing rate is selected and gradually increased by the rescuer till an electric capture is received with a pulse. It acts as a bridge till transvenous pacing or other therapies can be applied.
  • Epicardial Pacing: - This is used in an open-heart surgery. Electrodes are placed in contact with the outer wall of the ventricle. This maintains a cardiac output till a temporary transvenous electrode is inserted.
  • Transvenous pacing: - Transvenous pacing, is used as an alternative to transcutaneous pacing. It is used as a bridge to permanent pacemaker placement as it can be kept till the pacemaker is inserted or till there is need of the permanent pacemaker, after which it is removed.
  • Sub clavicular pacing: - An incision is made in the vein where the electrode lead is inserted and passed along the vein, through the valve of the heart till it is positioned in the chamber. The basic types of pacemakers are:
  • Single-chamber pacemaker

    In this type, only one pacing lead is placed into the chamber of the heart.

    Dual-chamber pacemaker

    Wires are being placed in the two chambers out of which one lead paces the atrium and one paces the ventricle. This type resembles the natural pacing of the heart

  • Biventricular pacing: - A Biventricular Pacing is used to achieve Cardiac Resynchronization Therapy (CRT).It can pace both septal and ventral walls of the left ventricle So, the pacemaker can resynchronize the ventricular contractions.


Procedure of Implantation
During the procedure an ECG and blood pressure monitor will allow your heart rate and blood pressure to be recorded while you lie on the table in the cardiac catheter laboratory. The local anaesthetic will be injected under the skin in the area of the pacemaker insertion.
An 5-10cm incision will then be made below the collar bone and a small pocket under the skin or muscle will be made for the pacemaker battery, and one or more leads will be inserted into a nearby vein so they can be passed to the heart using x-ray control. The cardiologist will then close the incision with sutures and apply a dressing to the skin over the wound. Simple generator replacements may be done as a day case.


Recent advances –
Implantable cardioverter defibrillators (ICDs)
ICD is a device similar to a pacemaker which sends larger electrical shock to the heart that helps it to pump again. Some devices contain both a pacemaker and an ICD. They are often used as a preventative treatment. If the ICD senses the heart is beating at a potentially dangerous abnormal rate, this sends electric shock which helps the heart to beat in a normal rhythm. A newer type of ICD in which the pacing lead is implanted under the skin.

'Dynamic Pacemaker', could compensate for both actual respiratory loading and potentially anticipated respiratory loading. other artificial organ replacement efforts and this would be supported by traditional tissue welding. Stem cells may or may not be of interest to transitional tissue welding.
The Pacemakers that control both the atria and ventricles are called dual-chamber pacemakers

Nano stim Leadless Pacemaker – It is one of the most innovative technologies. It is a tiny device which is implanted in the heart via chambers. It attaches to the wall of the left ventricular apex. The small size of the device allows for percutaneous placement in the femoral vein using a steerable catheter.

What is the Cost of Pacemaker Implantation?

  • The cost for Double Chamber Pacemaker Implantation is 7,500 USD.


What is the treatment duration?

  • The average hospital stay after the surgery is 5 - 7 days. Complete recovery of the patient will take a few weeks to several months, depending on the health before surgery. Regular exercise and physiotherapy will help to recover more quickly.


What is the success rate?

  • For a 3-lead pacemaker system, the success rates are about 97 percent. The risks of major complications from a pacemaker implant are low.

Pacemaker Hospitals in India

Cardiology Top 20. Top Ranked Hospitals for Cardiology in India. Get Opinion and cost estimate from any three Hospitals Times of India National Rank in Cardiology The Week National Rank in Cardiology
Medanta Hospital Gurgaon Delhi India
Medanta – The Medicity is one of India's largest multi-super specialty institutes located in Gurgaon, a bustling town in the National Capital Region. Founded by eminent cardiac surgeon, Dr. Naresh Trehan, the institution has been... + Read More
Size of Hospital (Beds) : 1,250
Accredited By :
  • JCI
  • NABH
1 5
Apollo Hospitals Chennai
In 1983 , the Apollo Group established the flagship hospital named as Apollo Hospital , Chennai. The Hospital has 60 departments organized by Internationally Trained Doctors , having hi-tech facilities of vaious health disorders and... + Read More
Size of Hospital (Beds) : 500
Accredited By :
  • JCI
  • NABH
2 7
Fortis Escorts Heart Institute - Okhla New Delhi India
Fortis Escorts Heart Institute and Research Center is revered as an enduring symbol of Cardiac Care in the country. A JCI Accredited Hospital, Fortis Escorts Heart Institute, offers sheer excellence in the field of Cardiology and Cardiac... + Read More
Size of Hospital (Beds) : 285
Accredited By :
  • JCI
  • NABH
3 2
Indraprastha Apollo Hospital Delhi India
The India’s First Hospital which is Internationally Accredited by Joint Commission International(JCI) is the Indraprastha Apollo Hospital, New Delhi. It is the best multi-speciality tertiary acute care hospitals with over 700 beds. It... + Read More
Size of Hospital (Beds) : 718
Accredited By :
  • JCI
  • NABH
4 9
Dr. Agarwal Eye Hospital, Chennai
Dr.Agarwal's Eye Hospital was founded by Late Dr.J.Agarwal (recipient of the Padma Bhushan award) and his wife Dr. T.Agarwal in Chennai, India, in 1957. What was initially an eye clinic and their home evolved into a modern eye hospital... + Read More
Size of Hospital (Beds) : 275
Accredited By :
  • JCI
  • NABH
4
Fortis Hospital Mumbai India
Fortis Hospital, Mulund is a JCI accredited, 300-bed multi-speciality tertiary care hospital providing a range of diagnostic and treatment services. With cutting edge technology, highly skilled and experienced surgeons and paramedical... + Read More
Size of Hospital (Beds) : 300
Accredited By :
  • JCI
  • NABH
5
Kokilaben Dhirubhai Ambani Hospital Mumbai India
Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute is India’s one of the most advanced tertiary care facilities. As the flagship social initiative of the Reliance Group headed by Anil Dhirubhai Ambani, the hospital is... + Read More
Size of Hospital (Beds) : 750
Accredited By :
  • JCI
  • NABH
6
Fortis Memorial Research Institute - Gurgaon India
Fortis one of their leading health care centers is located at Guargaon. Fortis hospital Guargaon Set up over 11-acres, with a provision of 1000 beds. The Fortis Memorial Research Institute (FMRI) is a quaternary care and multi-speciality... + Read More
Size of Hospital (Beds) : 1000
Accredited By :
  • JCI
  • NABH
9
Dr. L H Hiranandani Hospital Mumbai India
Dr L H Hiranandani was the inspiration behind the edifice. He was born in 1917 in Thatta, Sind (now in Pakistan). The family migrated to Mumbai in 1937. He completed his medical education in 1942. He was keen to further his education and... + Read More
Size of Hospital (Beds) :
Accredited By :
  • JCI
  • NABH
10
Apollo Hospitals, Bengaluru is a tertiary care leading unit of the Apollo hospitals group. It has made a presence in Bengaluru and reached 42nd Super Specialty Hospital of the crowd. It is a 250 bedded hospital, beautifully redesigned over... + Read More
Size of Hospital (Beds) : 250
Accredited By :
  • JCI
  • NABH
11
Apollo Hospital Hyderabad India
Apollo hospital , Hyderabad is the best hospital in the world , in terms of technical expertise , deliverables and outcomes. The first health city in Asia and a perfect example of an integrated healthcare system offering solutions across... + Read More
Size of Hospital (Beds) : 350
Accredited By :
  • JCI
  • NABH
13
Rabindranath Tagore International Institute of Cardiac Sciences Kolkata India
Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), Kolkata is a NABH accredited superspeciality tertiary care hospital established in the year 2000. It provides service to the people of West Bengal and neighbouring... + Read More
Size of Hospital (Beds) : 200
Accredited By :
  • JCI
14
Fortis Hospital Mohali India
Fortis Hospital Mohali (FHM) has been Internationally Accredited by Joint Commission International (JCI) since 2007 (renewed for the 4th time in 2016). It is also the proud recipient of accreditation from National Accreditation Board of... + Read More
Size of Hospital (Beds) : 344
Accredited By :
  • JCI
  • NABH
15
Narayana Health Bangalore India
We are headquartered in Bengaluru, India, and operate a national network of hospitals in India with a particularly strong presence in the southern state of Karnataka and eastern India, as well as an emerging presence in western and central... + Read More
Size of Hospital (Beds) : 250
Accredited By :
  • JCI
  • NABH
16 3
Continental Hospitals, A Gleneagles Facility Hyderabad India
Continental Hospitals is a part of the Parkway Pantai Ltd. Parkway Pantai is one of the region's largest integrated private healthcare groups with a network of 22 hospitals and more than 4,000 beds throughout Asia, including Singapore,... + Read More
Size of Hospital (Beds) : 750
Accredited By :
  • JCI
  • NABH
18
Max Super Speciality Hospital - Patparganj New Delhi India
Max Multi Speciality Hospital, Patparganj, subsidiary of Max healthcare that have 11 top hospitals in Delhi- NCR, Punjab and Uttarakhand with over 1900 bedding facilities including 525 ICU bedding, 2100 world class doctors. They follow a... + Read More
Size of Hospital (Beds) : 500
Accredited By :
  • JCI
19
Jaslok Hospital Mumbai India
Jaslok Hospital was set up in 1973 with a very simple mission. Our founders, Jasoti and Lokoomal Chanrai, wanted to ensure that we provide the best possible medical care using state-of-the-art technology to every single patient,... + Read More
Size of Hospital (Beds) : 600
Accredited By :
  • JCI
  • NABH
20