Is it possible to live with a disabled pacemaker? How long do people live with a pacemaker?

Heart disease remained incurable for several decades. But now cardiologists have the opportunity not only to “look” into the heart, to see how it works inside, but to make it work. The heart pacemaker became a real salvation; reviews from doctors and patients were always only positive.

The device seems to give people a “second chance” to live a full life again. The operation is not considered complicated; it takes only a few minutes. But do not forget that at first, for the first time after the operation, you need to listen to your condition and not overwork. To avoid problems in the future, you must follow the recommendations of doctors.

Basic information

An artificial heart pacemaker is a special electronic device. It has a built-in microcircuit that allows you to detect any changes in the functioning of the heart muscle. Thanks to the device, if necessary, myocardial contractions are corrected.

The device consists of the main elements:

Heart pacemaker: operating principle

Titanium case.
Connector block.
Electrodes.
Programmer.

The purpose of batteries is to produce the energy needed to create electrical impulses.

Microcircuits make it possible not only to obtain, but also to monitor electrodynamics.

The connection block is used to connect the electrodes and the housing. Electrodes are placed in the heart muscle, which allows information about the heart to be read. Carrying electrical charges help the heart muscle contract properly.

The programmer or computer is located in the medical institution where the operation to install the device was performed. Its role is to set or change pacemaker settings if necessary.

Installation of the device

How to install the device

Many people are interested in how the device installation process occurs. The operation is considered simple. The patient is prepared in advance, the necessary examinations are carried out. The process does not take long.

insert a special device into the subcutaneous fat tissue
place electrodes in various areas of the heart muscle

The operation is performed under local anesthesia. The following is done:

The patient makes an incision in the collarbone area.
Electrodes are inserted through a thin vein.
The device is connected to the heart.

Important! Despite the fact that the procedure is simple, all work on installing a pacemaker is carried out using special X-ray equipment.

After installing the device, people’s lives change, new rules, requirements appear, and some restrictions arise. But you can get used to everything. We must remember that the heart remains the same and must be protected.

The first days after installing the device

In the first days you need to adhere to the following:

monitor the postoperative wound to keep it clean and dry
if the person’s condition is good, there are no complications, then on the fifth day you can safely take a shower
Do not lift weights in the first week
Avoid heavy physical work around the house, such as snow removal

Most people return to work within a week after surgery.

We must remember! No matter how well you feel after installing a pacemaker, you must listen to your body. If you feel tired, you need to put things aside and rest a little.

Life a month after the device was installed

What examination is acceptable?

After a month, the person who has undergone surgery is allowed to play sports. But there can be no talk of heavy physical activity. Swimming, playing tennis and golf are allowed. Walking is especially useful.

You should visit your doctor regularly. The first appointment after surgery is three months after discharge. The second appointment should be after six months, and then a visit to the doctor should be at least once every six months.

If you experience anxiety or discomfort, you should consult a doctor immediately.

How to live on after having a pacemaker installed. Recommendations

Despite the fact that the device is equipped with special built-in protection against the influence and interference of other electrical devices, you still need to avoid powerful electric fields. Do not be afraid of household appliances such as: microwave oven, tape recorder, vacuum cleaner, refrigerator, computer and the like.

It must be remembered that in order to prevent interference, the devices must be located at a distance of no closer than a decimeter from the area where the cardiac device is installed.

How to save your heart and the installed device

There are a number of rules that must be followed in everyday life:

Do not touch the area where the cardiac device is installed to the operating TV.
Do not lean against the front wall of the microwave oven.
Do not stay near high-voltage power lines.
Do not stand near welding equipment.
Stay away from electric steel furnaces.

Remember not to go through security controls, both at airports and in stores. To avoid trouble, you should always have your cardiac device owner’s card and passport with you. The card can always be obtained at the hospital.

If an examination is prescribed such as: radiation therapy, diathermy, magnetic resonance diagnostics, external defibrillation, then first of all you need to inform the doctors that you have a pacemaker installed.

Fluorography and x-rays are not contraindicated. Sometimes radiography is prescribed if there is the slightest suspicion of electrode failure.

Important! You should not sunbathe in the open rays of the sun. In hot weather, you should always wear cotton clothing on your body.

The battery in the device is designed to last for a decade. When the expiration date is approaching, the device will sound a signal. The signal will be recorded during a routine examination. The battery will be replaced immediately. Therefore, it is important to visit your doctor on time and regularly.

Reviews about the pacemaker

On the forums you can read different reviews about the pacemaker, both positive and negative. But experts note that negative reviews often have nothing to do with the work of the pacemaker. Often problems are associated with other existing diseases in people, for example, the presence of neurology. People with this diagnosis often complain of “tingling” in the heart area.

It was noted that people with pacemakers allow themselves to travel to the south. There are restrictions and prohibitions on sunbathing, but if you do not abuse your exposure to the sun, then there is nothing terrible for your health.

People who have had a pacemaker installed note that they have the opportunity to once again lead an active lifestyle and live a full life. You need to listen to the recommendations of doctors and undergo scheduled examinations in a timely manner.

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Pacemaker: what are the contraindications after its installation?

The installation of pacemakers in patients with cardiovascular diseases has been practiced all over the world for many years.

The main purpose of this device is to maintain normal contraction of the myocardium of the heart, as well as to prolong the life of the body.

Radical indications for installing a stimulator

Installation of a pacemaker is mandatory if:

The patient is diagnosed with bradycardia, accompanied by constant dizziness and fainting;
cessation of bioelectrical activity of the heart for 3 or more seconds (can be monitored by performing an ECG);
2-3 degree atrioventricular block is supplemented by other cardiopathy;
development of heart block after myocardial infarction.

development of heart block after myocardial infarction

When the installation of a stimulator is absolutely necessary, it can be carried out in an emergency and without undergoing additional preoperative studies.

development of atrioventricular block, but without pronounced symptoms;
Fainting conditions of the patient due to intraventricular blockades, while no other causes of fainting are observed.

In cases where the installation of the device is only recommended and is not mandatory, the patient independently makes the decision to implant a pacemaker.

heavy physical activity when installing the device is contraindicated

Installation of a pacemaker: do's and don'ts?

A device such as a pacemaker has its justified contraindications. The main ones are exposure to electromagnetic fields and physical activity, which impair the operation of the device. Before any examination, it is mandatory to warn about the presence of an implant.

After installing a pacemaker, the following contraindications exist in the patient’s life:

MRI examination;
heavy physical activity;
be near electrical substations;
carry a mobile phone or magnets in your breast pocket;
stay close to metal detectors for a long time;
Carrying out cholelithotripsy (shock wave treatment) only after preliminary adjustment of the pacemaker.

First 7 days after implantation

In the first week after installation of a pacemaker, you must adhere to the following recommendations:

The postoperative wound should be kept sterile and dry. Treatment is carried out according to the recommendations of the doctor and medical personnel;
if no complications are observed in the first 4-5 days, the incision site successfully regenerates, then you are allowed to take a non-hot shower;
Until the wound is completely healed, lifting weights over 5 kg is prohibited.

The most suitable physical activity is walking

First month after implantation

As mentioned above, if you have a pacemaker, physical activity is not allowed, but this applies to heavy and prolonged exercise. The most suitable physical activity is walking, and its duration is chosen individually by the patient. If in the first six months the patient’s health is satisfactory, there are no deviations in the operation of the pacemaker, then you can resort to other light sports, for example, visiting the pool or table tennis.

It is also necessary to regularly visit a cardiologist; a routine examination for patients with pacemakers is once every 6 months.

How to live after having a pacemaker installed?

There are no restrictions that could significantly affect the patient’s life. It is allowed to use all household appliances: refrigerator, radio, microwave oven, computer, etc. However, in order to protect the device from possible damage, you should not approach all household appliances closer than 15 cm. Avoid any contact with the welding equipment. equipment and high-voltage wires. Upon discharge, the patient is given a passport for the pacemaker, where all restrictions and recommendations are carefully described.

It is advisable not to hold the phone near where the pacemaker is located.

As for the use of mobile phones, there are no obvious contraindications, however, communication should not be prolonged. It is advisable not to keep the phone near where the pacemaker is located.

As mentioned above, sports are allowed, but only light types. Under no circumstances should you engage in combat sports or others where the risk of injury is high. Any, even minor blow to the gastrointestinal tract and thoracic region can seriously damage the functioning of the pacemaker.

Life expectancy after pacemaker installation

If we talk about life expectancy after installation of an pacemaker, then the patient’s regularity of visiting the doctor plays a role here. The operating time of the device is on average from 7 to 9-10 years. When the time comes to change the battery, the device will emit a special signal during the examination. It is for this reason that it is believed that the patient’s life span directly depends on the frequency of visits to the cardiologist.

The operating time of the device is on average from 7 to 9-10 years

The lifespan of patients who regularly follow doctors' recommendations and undergo routine examinations is the same as that of people without an pacemaker.

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How long do people live with a pacemaker?

There is a legend that the first patient with an implanted pacemaker outlived the developer of the pacemaker himself. I don’t presume to judge its veracity - here’s how you look at it: the creator of the world’s first implantable IVR, Rune Elmqvist, died in 1996 at the age of 90, and his patient Arne Larsson died in 2002, at the age of 86. The technical patient survived the doctor. However, Larsson was given the device in 1958, and he died in 2002 - 44 years later. Moreover, they installed him not with a modern device, but with the first one, which was not technically perfect.

Doctors, in response to the question of how long people live with a pacemaker, usually answer that the average life expectancy of a patient with the device often exceeds the average life expectancy of a person without the device.

An artificial heart pacemaker (APM) reduces the risks of coronary artery disease and cardiac arrest, eliminates the symptoms of atrial fibrillation and bradycardia and other diseases. After installing an pacemaker, a person is more protected from possible complications of heart disease, which usually accompany the natural aging process of the body. Moreover, the device is capable of saving a person’s life in conditions of severe hypothermia, when the risk of cardiac arrest sharply increases.

There is no exact answer to the question of how long people with heart pacemakers live. At least, the count is not for years, but for decades - subject to certain rules of behavior (do not stay in strong magnetic or electromagnetic fields for a long time, if possible avoid them altogether; do not engage in contact-traumatic sports and do not scuba dive and some others) people with pacemakers live for decades. ECS is not a limiter on life expectancy.

To be honest, the question of how long a person with a pacemaker lives, as well as how safe the operation is, did not arise for me either while in the hospital (cardiac center) or after discharge. The doctors managed to quite clearly convey the simple idea that you can live with an implanted device for years and decades, without forgetting to regularly check the device’s battery charge. In addition, I witnessed the story of an 80-year-old grandmother who had ECS for 14 years and continued to live peacefully with it.

It is much more appropriate to ask what is the lifespan of a pacemaker between replacements of the battery or the IVR itself (in other words, how long does the pacemaker last). Here everything depends on the operating mode of the pacemaker: in rare cases, this period is 3-4 years, although usually the devices are designed to operate for 7 - 8 years (then it is considered that the device is becoming obsolete and needs to be replaced - this is more true for foreign models). It is not uncommon for people to live with one pacemaker for 12–14 years or more. They say that Russian models without frequency adaptation, provided that they do not work non-stop, can last up to 30 years!

How long can you live with a pacemaker?

So, with one pacemaker between two operations you can live from 3 – 4 to 30 or more years. Personally, for my device the manufacturer sets a service life of 7-8 years. How long is it or not? It takes approximately 6 – 8 months for a scar to form and about a year for the final implantation of the device (in general, the terms vary – from 3 to 12 months).

How long do they live with a pacemaker after this? Approximately 6 – 7 years before replacement (and if you are lucky and the device does not “spun” without stopping, then 13 – 14). Of course, there are unpleasant situations when the pacemaker does not take root, and it has to be changed every 1 - 2 years, but such cases are not frequent.

How long do people with pacemakers live in general? As long as the restrictions are observed and the patient monitors their health, life expectancy is not limited by anything, including the number of possible IVR replacements.

Initially, the pacemaker is installed in the left shoulder, then the battery can be replaced, and the device itself, along with the electrodes, will remain in place. A new device instead of the old one can be installed here with new electrodes (if, for example, they were pulled out of the vessels - or if they were removed surgically).

Finally, implantation is possible in another place - in the right shoulder or abdominal cavity. At least the number of repeated operations is not limited to 2-3 - there was a guy in the room with me who had almost a dozen operations. This, of course, is not very pleasant, but, in general, it is not fatal. In total, the answers to the question of how long people live with a pacemaker are as follows:

the overall life expectancy with regular justified replacements is tens of years, in some cases much longer than in people without ECS (preventive motives) and in many (if not all others) no less; The service life of the device, if it has taken root normally (the network names different percentages of “without consequences” and rejection - usually 92 - 98%), is 7 - 8 years under normal conditions, and 3 - 4 years if the device works “non-stop” (if it functions as insurance, then for all 14 - 16 years, and sometimes more than 20).

How long do people with pacemakers live active lives? There are known cases of continuing to play sports with an ECS: at the amateur level, alpine skiing, a professional hockey career (although, in general, game sports where a push or blow is possible are prohibited), mountaineering (and in these cases the device saved the lives of people in conditions of hypothermia ).

Childbirth is not prohibited (although not every maternity hospital is eager to “get involved” with a woman in labor with an ECS - but this is a question for the conscience of individual doctors), professional activities not related to the maintenance of electrical installations and power lines, etc. All this does not reduce the allotted operating time of the device and does not affect human life expectancy.

Life expectancy with a pacemaker

So, from a medical point of view, life expectancy with a pacemaker is determined primarily by the general health of the patient and does not depend on the presence of IVR.

Only in the first time after the operation, the patient is advised to limit his activity: he should not lift heavy objects, work in an inclined position, etc. If you subtract these two or three months after the operation to install (implant) the device, then the pacemaker and the duration of active life also do not depend much on each other.

worrying less, resting more and being calmer about everything is, of course, difficult to implement, but this will help maintain the heart rhythm in a normal state; drink less alcoholic beverages, and definitely don’t get drunk - alcohol, again, disrupts the heart rhythm, which can lead to the development of tachycardia (the stimulator will skip beats when an impulse is needed, and send an impulse to the heart when it is already beating normally) ; lead a moderately active lifestyle, i.e. It’s no longer possible to lift “iron” (including because the electrical impulse sent to the contracting pectoral muscle can interfere with the work of the pacemaker), but walking and running, swimming is fine.

In general, the life expectancy of people with a pacemaker has no correlation with the very fact of having a pacemaker installed, subject to restrictions. It is necessary to remember the prohibitions, undergo timely examinations, not violate contraindications, avoid heavy physical work (including monotonous work - in order to avoid the electrode coming off) - and you can lead a full life!

Does a pacemaker have a greater effect on life expectancy? How much does a pacemaker prolong life and does it prolong it at all? No doctor can predict how much ECS can extend life expectancy. The task of IVR is to prevent death in the event of an attack of arrhythmia or blockade.

Throughout life, a medical history is maintained with the pacemaker. The history of a patient with a pacemaker begins with an anemnesis (a record of information about the patient's condition obtained from the patient himself or his relatives).

How do people with pacemakers die?

According to observations of patients with pacemakers, death occurs longer: the pacemaker sends impulses to an already stopped heart, forcing it to beat again and again. Death with a pacemaker can be quite difficult and long-lasting. However, the strength of the IVR impulses is not enough to start the heart, if it is no longer capable of contracting itself.

There is virtually no alternative to ECS. Some types of arrhythmias can be supported by medications, but they all have side effects - so for a young body there are no options: it is better to put a pacemaker.

Death with a pacemaker is diagnosed not by indicators of cardiac function, but by the functioning of the central nervous system (CNS) - based on data from the ultrasound procedure of transcranial vessels (sometimes EEG) and a decision is made to register death (or to continue/start resuscitation).

More than three hundred thousand permanent pacemakers (pacers) are installed around the world each year because patients with some severe heart lesions require an artificial pacemaker.

Types of pacemakers

A pacemaker is an electronic device that generates electrical impulses using a special circuit. In addition to the circuit, it contains a battery that supplies energy to the device and thin wires-electrodes.

There are different types of heart pacemakers:

single-chamber, which are capable of stimulating only one chamber - the ventricle or atrium; dual-chamber, which can stimulate two cardiac chambers: both the ventricle and the atrium; Three-chamber pacemakers are required for patients with heart failure, as well as in the presence of ventricular fibrillation, ventricular tachycardia and other life-threatening types of arrhythmias.

Indications for installation of a pacemaker

Are you still wondering what a pacemaker is for? The answer is simple - an electrical pacemaker is designed to impose the correct sinus rhythm on the heart. In what cases is a pacemaker installed? To set it, there can be both relative and absolute indications.

Absolute indications for a pacemaker

Absolute indications are:

bradycardia with pronounced clinical symptoms - dizziness, syncope, Morgagni-Adams-Stokes syndrome (MAS); episodes of asystole lasting more than three seconds, recorded on the ECG; if during physical activity the heart rate is recorded below 40 per minute; when persistent atrioventricular block of the second or third degree is combined with two-bundle or three-bundle blockades; if the same blockade occurs after myocardial infarction and manifests itself clinically.

In cases of absolute indication for the installation of a pacemaker, the operation can be performed either planned, after examinations and preparation, or urgently. With absolute indications, contraindications to the installation of pacemakers are not taken into account.

Relative indications for pacemaker

The relative indications for a permanently implanted pacemaker are as follows:

if third-degree atrioventricular block occurs at any anatomical site with a heart rate under a load of more than 40 beats, which is not clinically manifested; the presence of atrioventricular block of the second type and second degree without clinical manifestations; syncope in patients against the background of two- and three-fascicular blockades, not accompanied by ventricular tachycardia or transverse block, while it is not possible to establish other causes of syncope.

If a patient has only relative indications for undergoing surgery to install a pacemaker, the decision to implant it is made individually, taking into account the patient’s age, physical activity, concomitant diseases and other factors.

When is the installation of a pacemaker not justified?

In fact, a pacemaker has no contraindications for its installation, except in the case of its unjustified implantation.

Such insufficient grounds for implantation are:

first degree atrioventricular block without clinical manifestations; proximal atrioventricular block of the first type of the second degree, without clinical manifestations; atrioventricular block that can regress (for example, caused by medication).

How is a pacemaker placed?

Now let's talk about how a pacemaker is installed. If you watch a video of how a pacemaker is installed, you will notice that the cardiac surgeon performs it under X-ray control, and the total procedure time varies depending on the type of implanted device:

a single-chamber pacemaker will require half an hour; for a two-chamber pacemaker – 1 hour; A three-chamber pacemaker requires 2.5 hours to install.

Typically, surgery to install a pacemaker occurs under local anesthesia.

The operation to implant an pacemaker consists of the following steps:

Preparing for surgery. This includes debridement of the surgical site and local anesthesia. An anesthetic drug (novocaine, trimecaine, lidocaine) is injected into the skin and underlying tissues. Installation of electrodes. The surgeon makes a small incision in the subclavian region. Next, the electrodes under X-ray control are inserted sequentially through the subclavian vein into the desired cardiac chamber. Implantation of the pacemaker housing. The device body is implanted under the collarbone, and it can be installed subcutaneously or deepened under the pectoral muscle.

In our country, the device is more often implanted in right-handed people on the left, and in left-handed people on the right, which makes it easier for them to use the device.

The electrodes are connected to the already implanted device. Device programming. It is produced individually to suit the patient’s needs, taking into account the clinical situation and the capabilities of the device (which also determine the cost of the pacemaker). In modern devices, the doctor can set the basic heart rate, both for the state of physical activity and for rest.

Essentially, this is all the basic information about how a pacemaker is installed.

Complications after pacemaker installation

It is worth knowing that complications after installing a pacemaker occur in no more than 3-5% of cases, so you should not be afraid of this operation.

Early postoperative complications:

violation of the tightness of the pleural cavity (pneumothorax); thromboembolism; bleeding; violation of insulation, displacement, fracture of the electrode; infection of the surgical wound area.

EX syndrome - shortness of breath, dizziness, decreased blood pressure, episodic loss of consciousness; pacemaker-induced tachycardia; premature failures in the ECS.

Surgery to insert a pacemaker should be performed by an experienced surgeon under X-ray guidance, which avoids most of the complications that arise at an early stage. And in the future, the patient must undergo regular examinations and be registered with a dispensary.

If there are complaints about deterioration in health, the patient should immediately consult with the attending physician.

What can and cannot be done if you have a pacemaker?

Living with a pacemaker has limitations regarding physical activity and electromagnetic factors that may prevent the device from working correctly. Before any examination or course of treatment, it is necessary to warn doctors about the presence of an pacemaker.

Living with a heart pacemaker imposes the following restrictions on a person:

undergo an MRI; engage in hazardous sports; climb high-voltage power lines; approach transformer booths; put a mobile phone in your breast pocket; stay close to metal detectors for a long time; undergo shock wave lithotripsy without preliminary adjustment of the pacemaker or perform electrocoagulation of tissues during surgery.

Cost of installing a pacemaker

Basically, since pacemaker implantation is paid for by the compulsory medical insurance fund, the cost of installing a pacemaker is usually zero.

But sometimes patients themselves pay for it and additional services (this applies to foreigners and people who do not have compulsory medical insurance).

The following prices apply in Russia:

implantation of a pacemaker – from 100 to 650 thousand rubles; implantation of electrodes – minimum 2000 rubles; surgical manipulations – bran; Staying in the ward costs at least rubles per day.

The overall cost is most influenced by the ECS model and the prices of the selected clinic. For example, in a provincial cardiology center, simple implantation of an outdated domestic pacemaker model can cost a minimum of rubles. In large vascular clinics that use modern imported devices and provide additional services, the cost jumps to 300 thousand rubles.

How to behave after installing a pacemaker?

First postoperative week

The postoperative wound should be kept clean and dry according to the recommendations of the medical staff. If the early postoperative period is favorable, five days after surgery it is already permissible to take a shower, and a week later most patients return to their usual work schedule. To prevent the seams from coming apart, you should not lift more than 5 kg for the first time. You cannot do heavy housework, but when doing lighter work, you need to listen to how you are feeling and immediately put off work if any unpleasant sensations appear. You can't force yourself.

One month after surgery

Exercising after having a pacemaker installed is not only useful, but also necessary. Long walks are beneficial. But tennis, swimming pool and other strenuous sports will have to be postponed for a while. Over time, the doctor monitoring the patient's health may remove some restrictions regarding sports. You need to visit the doctor according to plan: after 3 months - the first examination, after six months - the second, and then every six months or a year.

If a person feels discomfort or anxiety about the operation of the pacemaker, then they should consult a doctor immediately.

Life after pacemaker implantation

Electrical devices. Although pacemakers are equipped with protection against interference from other electrical devices, strong electric fields should still be avoided. The use of almost all household appliances is allowed: TV, radio, refrigerator, tape recorder, microwave oven, computer, electric razor, hair dryer, washing machine. To avoid interference, you should not approach the pacemaker implantation site closer than 10 cm to an electrical appliance, lean against the front wall of the microwave (and generally avoid it) or the screen of a working TV. You should stay away from welding equipment, electric steelmaking furnaces, and high-voltage power lines. It is not advisable to go through control turnstiles in shops, airports, and museums. In this case, upon discharge from the hospital, the patient is given a device passport and an owner’s card, which must be presented during the search, after which it can be replaced by a personal search. The KS is also not afraid of most office equipment. It is advisable to develop the habit of grasping appliance plugs and other voltage sources with the hand further away from the pacemaker. Mobile phone. Long conversations on it are undesirable, and you need to hold the receiver 30 cm or more from the CS. When talking, hold the tube to the ear on the opposite side of the implantation site. Do not carry the handset in your breast pocket or around your neck. Sport. It is prohibited to engage in contact and traumatic sports, that is, team sports, martial arts, since any blow to the abdominal cavity or chest can damage the device. For the same reason, shooting with a gun is not recommended. With a pacemaker, you can return to walking, swimming and such physical exercises that allow constant monitoring of your well-being and allow you to follow safety rules.

The area of the body where the pacemaker was implanted should not be exposed to direct sunlight. It should be kept covered with some kind of cloth at all times. Also, avoid swimming in cold water. It is especially important for car enthusiasts to remember that they should not touch live wires while repairing a car or replacing a battery.

Validity period and how long do people live with a pacemaker?

On average, the lifespan of a pacemaker is determined by the capacity of the battery, designed for 7-10 years of operation. When the battery life is approaching, the device will give a signal during the next scheduled examination. After this, you should replace the battery with a new one. Therefore, the question of how long people can live with a pacemaker also depends on the regularity of visiting the doctor. There is an opinion that, being a foreign body, the CS can harm a person. This is not at all true, despite the fact that often there is no alternative to installing it. In order to continue a fully fulfilling life, you have to put up with only minor restrictions that are worth it. In addition, it can be installed completely free of charge.

You can often hear the question of how long people can live with a pacemaker, especially from those for whom such surgery is recommended. Medical practice shows that people with an implanted pacemaker, provided they follow all the doctor’s recommendations, live no less than other people.

In other words, having a pacemaker can only prolong life, not make it shorter.

Have you already had a pacemaker installed? Or do you still have to undergo this operation? Tell your story and feelings in the comments, share your experience with others.

A heart pacemaker is a fairly miniature device that, by sending electrical impulses, supports the normal contraction of an important organ to ensure the necessary vital functions of the body. The pacemaker is powered by lithium batteries. The design of the electrical pulse generator includes a control system and electrocardiographic sensors that monitor the heart rhythm.

When is a pacemaker placed?

Indications for installing a pacemaker are:

all types of bradycardia, when the heart rate is less than 60 per minute; atrioventricular blockade.

There are practically no contraindications to implantation of a heart pacemaker, but there are a number of factors that increase the risk of complications, including:

bleeding disorders; overweight; smoking and excessive alcohol consumption; regular use of certain medications. Surgery to install a pacemaker

Preparation for surgery includes:

blood tests; performing a chest x-ray; taking an electrocardiogram.

Pacemaker implantation is carried out under local anesthesia, when only the operated area is numbed with injections. The surgeon makes an incision in the collarbone area through which the device is inserted. Small wires are connected to the heart muscle through a vein located under the collarbone. The operation time is about 2 hours.

Rehabilitation after installation of a pacemaker

After the operation, pain may be felt. The doctor prescribes painkillers to reduce pain. The pacemaker is customized to suit your individual heart muscle stimulation needs. The specialist must instruct the patient in detail about possible complications and how to ensure a quick recovery after surgery. As a rule, for normal rehabilitation you need to follow the following rules.

In a normal state, the work of the heart muscle occurs completely unnoticed by humans. As the physical or psycho-emotional state changes, the heart slows down or, on the contrary, increases the intensity of its work, pumping different volumes of blood and thereby ensuring timely enrichment of all organs with oxygen. But despite its extremely important role in life support, the heart is by no means immune from “problems.” Their treatment can be carried out by therapeutic or surgical methods. In some cases, a decision may be made about the need for an additional assistant to the main pump of the body - a heart pacemaker is installed.

Operating principle of the device and indications for implantation

A pacemaker is a small electrical device that, once implanted in the body, is designed to artificially create electrical impulses and ensure regular heartbeats. In essence, this device is a customizable pacemaker, which, in the process of its operation, “imposes” the correct beat on the heart.

Installing a pacemaker is a rather serious and responsible step that requires good reasons. The process itself is invasive. The unjustification of implantation is the only contraindication to its implementation.

The decision to undergo surgery is made on a strictly individual basis, depending on the clinical picture of the underlying disease, concomitant diagnoses, age, gender, and lifestyle of the patient. However, there are a number of diagnoses, the formulation of which is an absolute indication for pacemaker implantation.

These include:

bradycardia with severe symptoms - a decrease in heart rate to less than 50 beats per minute;
complete heart block - discrepancy between the rhythms of the atria and ventricles;
severe heart failure;
some forms of cardiomyopathies, in which the resulting structural changes significantly affect the contractile activity of the heart.

Artificial pacemakers can be:

single-chamber, regulating the functioning of only one part of the heart - the atrium or ventricle;
two-chamber, perceiving and stimulating simultaneously two chambers of the organ;
three-chamber, having a special device for the treatment of heart failure.

The development of science and technology has divided all pacemakers into frequency-adaptive ones, which automatically increase the frequency of generated impulses with increasing physical activity, and non-frequency pacemakers, which work in accordance with specified indicators. The requirements of modern life have forced each of the devices, especially imported ones, to be equipped with many additional parameters and functions that allow the device to be maximally adapted to each patient.

Sequence of actions when installing a pacemaker

The operation to install a pacemaker can last from forty minutes to three and a half hours, depending on the type of device. In general, any of the stimulators consists of an electronic circuit - a pulse generator and conductor electrodes. The power source for the device is a battery, designed for an average of 7-8 years of continuous operation. To avoid rejection of the foreign body by the body, the circuit is placed in a titanium case.

The invasive intervention is performed by a cardiac surgeon under the control of X-ray equipment. The presence of an anesthesiologist is also mandatory, despite the fact that in most cases local anesthesia is used.

Direct implantation includes the following steps:

tissue incision in the collarbone area;
sequential insertion of electrodes through the subclavian vein into the corresponding parts of the heart;
placing the stimulator body in the prepared bed;
connecting electrodes to the body;
individual setting of the device operating mode.

In order not to create discomfort in the patient’s daily life, modern devices are programmed in the “on demand” mode. This means that the device delivers impulses until the heart begins to contract on its own in the desired rhythm, after which the device turns off - the next time it turns on when the organ stops sending a signal in a timely manner.

Basic laws of life with a pacemaker

Implantation of a pacemaker conventionally divides the patient’s life into “before” and “after”. The new rules after surgery include a number of requirements and restrictions, compliance with which should become the daily norm. Reviews from people who have been living with a pacemaker for several years generally indicate an increase in the quality of life after its installation. Strict adherence to the instructions will allow you to avoid complications, side effects, and painlessly and quickly adapt to new living conditions.

Life with a pacemaker is divided into three stages, each of which has its own requirements:

first week after surgery;

During this period the patient is in the hospital. Under the close supervision of the attending physician and medical personnel, the sutures heal. It is important to keep the surgical wound clean and dry. The cardiologist takes regular measurements of heart rate. In the absence of negative factors, on the fifth day after implantation it is already possible to take a light shower, and a week later the patient is discharged from the medical institution.

the first three months with the device;

A person with a pacemaker is placed on a dispensary register. The first scheduled examination is carried out after three months. However, you should immediately consult a doctor if the patient feels unwell, dizziness, tachycardia, swelling or pain in the area where the device is installed, unreasonable attacks of hiccups occur, or any sound signals from the device are heard. During this period, it is recommended to listen especially carefully to your body. The mode of life and work should be as gentle as possible. Lifting loads heavier than five kilograms is prohibited. Even light work should be done with the hand opposite the pacemaker area.

the remaining period until the batteries are replaced;

Six months later, a follow-up examination of the patient is scheduled again; from this point on, the frequency of visits to the cardiologist is normally once every six months. Skipping scheduled procedures is prohibited. Even if the date of the examination coincides with the period of the business trip, you must find out in advance about the possibility of undergoing a scheduled consultation at local clinics.

If there are no warning factors, your doctor may gradually lift some restrictions. However, among them there are those that are permanent, regardless of the time after implantation of the pacemaker and the patient’s well-being.

Sports activities with an artificial pacemaker

There is a misconception that sports and life with a pacemaker are incompatible concepts. This is not entirely true. There are a number of sports activities and physical exercises that, six months after installation of the device, are not only not contraindicated, but are also extremely beneficial for the cardiovascular system, namely:

measured swimming without diving,
hiking and race walking,
gymnastics and yoga,
golf,
tennis.

The main rule in training should be moderation - you cannot overexert yourself and do something through force. Diving, rifle and shotgun shooting, powerlifting, as well as all contact sports during which the patient may receive a blow to the area of the installed pacemaker are prohibited.

The number of workouts, their duration and feasibility should be agreed with the treating cardiologist.

What to watch out for at home

A pacemaker is a device that responds extremely sensitively to changes in the surrounding magnetic field.

This circumstance must be taken into account in life “after” implantation. Reviews indicate that among the electrical appliances that surround a person in everyday life, the most dangerous are a microwave oven, a TV, and a power tool (hammer, drill, jigsaw). It is not recommended to approach these devices while they are running. As for the mobile phone, it also belongs to the risk group. It is hardly possible to completely abandon this “good” in the modern world. But you will have to minimize its use, as well as carry it not in your pocket, but in a bag or purse.

A heart pacemaker is an absolute excuse to avoid a metal detector test. However, in order to avoid awkward situations, you should have with you the passport of the owner of the pacemaker, which is issued upon discharge from the hospital.

Caution should also be exercised when undergoing medical examinations for concomitant diagnoses. Some types of tests are prohibited for people with a pacemaker. Despite the fact that the fact of implantation is usually indicated in the patient’s medical record, it should be reminded of it when visiting any doctor. In addition, the installation of the implant should be reported to all those who most often surround the patient, be it relatives or the workforce. This will make it possible to react promptly and correctly in the event of emergency situations in the work of the pacemaker.

Despite the many positive reviews about living with a pacemaker, it should be remembered that an artificial pacemaker is by no means a new heart or a cure for disease. This is just an opportunity to live, observing the safety rules.

serdcezdorovo.ru

Types of pacemakers

Pacemakers are divided into two types: standard, which “triggers” the contraction of the heart chambers, and internal, which combines the functions of a “regular” pacemaker and defibrillator (cardioverter-defibrillator).

Standard KS sends an electrical impulse through special wires that are attached to the heart. This helps in situations where a person with a rhythm disorder has a problem generating a natural electrical signal.

The second type of CS is a combination defibrillator/standard pacemaker. In addition to acting as an artificial pacemaker, which allows you to control the heart rate and their regularity, it can stop the “lethal rhythm” (a life-threatening arrhythmia).

The function of a defibrillator is to deliver a “shock” to the heart to force it to contract effectively. The idea of shock is the same as with a “manual defibrillator”, which many have seen on TV, for example, when an ambulance crew performs resuscitation. Since the wires are connected directly to the heart, the shock is much less powerful. Thanks to this, the “electric shock” with a cardioverter-defibrillator is not so painful.

Installing a CS does not always solve the arrhythmia problem one hundred percent. It is quite common to take medication after having a pacemaker installed to help the heart pump more efficiently. It is necessary to strictly follow the doctor's instructions, and also keep records of the medications used (time of administration, their doses).

Useful video

To learn how a pacemaker interacts with the heart, watch this video:

Risks associated with the operation

In addition to the general risks that any surgical intervention and anesthesia carry, there are problems associated specifically with the operation of implanting a CS. Statistics show that 5% of patients experience complications after installation pacemaker that they should be aware of. These include:

nerve damage in the area of tissue dissection;
pneumothorax (lung collapse);
bruising at the site of the CS (a common side effect of surgery, its severity depends on the amount of accumulated blood);
damage to tissue or blood vessels near the heart;
a faulty pacemaker that does not work properly after surgery (very rare);
a defect in the wire through which the electrical signal travels from the pacemaker to the heart (also observed very rarely);
wire rupture, which can occur after surgery due to improper placement;
infection of a postoperative wound.

Recovery after surgery

Rehabilitation after installation of a pacemaker usually lasts from a week to a month. Below are some tips on how to behave during the recovery period. You should find out more detailed information from your doctor. Only he can tell you in detail about the necessary lifestyle adjustments depending on the specific situation. What you should pay attention to:

You should try to avoid lifting heavy objects and excessive physical activity. This will allow the postoperative wound to heal faster and the pacemaker to “fix.”
Eliminate pressure after installing the pacemaker on the area where it is placed in the tissue.
Tell your doctor if there is swelling, redness, or discharge from your surgical wound.
Contact your doctor if your low-grade fever does not disappear within 2 days.

One of the complications of pacemaker implantation that can occur in the long term is swelling of the left upper extremity.

Wires from the device to the heart first enter a vein that runs upward along the chest wall. Through it they enter the vein through which blood flows from the upper limb. The wires then penetrate the superior hollow and the heart. They are quite thick, which can cause inflammation of the veins and their narrowing - this leads to congestion in the arm and its swelling.

When your arm hurts after installing a pacemaker, this may be one of the symptoms of inflammation of the vein. The condition is diagnosed using ultrasound or venography. The last procedure involves the introduction of a contrast agent. If the diagnosis is confirmed, this problem can be resolved with balloon angioplasty. Another option is to move the wires from the damaged vein to another.

To see how quickly the patient gets used to the pacemaker and what sensations he experiences, watch this video:

Life with a pacemaker: on the street and at home, medical procedures

Contrary to popular belief, there are no strict restrictions after having a pacemaker installed related to household appliances. Even a microwave oven has no effect. However, there are devices that require specific attention and certain precautions.

Devices requiring special attention	Rationale
Cellular telephone	If it is kept close to the pacemaker (for example, constantly placed in a chest pocket), this may affect its function. Problems should not arise if the phone is at a distance of more than 10 centimeters
Magnets	Like cell phones, they can affect the CS if they are kept close to him at a distance of less than 10 centimeters
Anti-theft detectors, motion sensors (for example, store alarm)	Generate electromagnetic waves that may interfere with the pacemaker. To avoid problems, you need to leave the area affected by these electromagnetic waves - just continue moving without stopping in front of the sensor
Metal detector frames at the airport	The frame metal detectors used by the security service do not interfere with the operation of the pacemaker. However, a portable (handheld) scanner may contain a magnet, which is a potential hazard. Therefore, before undergoing the inspection procedure, it is necessary to inform the airport security representative about the installed pacemaker
Full body scanners used at airports	There is conflicting evidence regarding these machines, which create a full-body image of a person on a screen. Therefore, before undergoing the procedure, it would be a good idea to inform the airport security representative about the installed pacemaker.
Electric arc welding	Unlike household appliances, welding machines, which use an electric arc to heat and melt metal, seriously affect the electrical circuits of the device. Therefore, one of the contraindications after installing a pacemaker is working as an electric welder.
MRI	Scanners that use the magnetic resonance effect can disrupt the operation of a pacemaker, and under certain conditions can completely disable it. This problem can be avoided if you first discuss all the risks of the procedure with your doctor.
Radiation therapy	Powerful ionizing radiation, which is used in the treatment of cancer, can damage the electrical circuits of the CS. This problem can be solved by special shielding of the device, which avoids its exposure to the irradiation field.
Other medical procedures	Pacemakers can also be damaged during lithotripsy, which uses sound waves to break up gallstones and kidney stones. Transcutaneous electrical stimulation of nerves/muscles used for pain relief, or heating of tissues using electromagnetic radiation - procedures that affect the function of the pacemaker

For a patient who has a pacemaker installed, it makes sense to remind any doctor (dentist, cosmetologist, etc.) about his peculiarity before undergoing medical manipulation.

The above recommendations are not so burdensome. Completing them is not such a difficult task. You just need to be careful. This will allow you to quickly return to your normal life after installing a pacemaker and avoid serious problems.

Physical activity and sports

Having a pacemaker does not mean that exercise is contraindicated. There are certain rules of behavior in active physical activity:

Avoid excessive stress on the muscular system of the upper half of the body. During the first month, it is necessary to minimize motor activity in the arm on the implantation side.
Avoid pressure and impacts in the area where the CS is installed. Practicing various types of martial arts (karate, boxing, judo) and weightlifting must be completely limited. You should also not engage in rifle shooting.
Team sports, for example, basketball, volleyball, hockey, are limited to the red line. On the one hand, with them the amplitude of hand movement is maximum, which can lead to detachment of the electrodes; on the other hand, the danger of serious trauma to the implantation area cannot be ruled out.
Hiking, fitness, swimming, dancing are the best options for people with pacemakers.

Regular checkups

Monitoring visits to the doctor are an integral part of the treatment process. Even if the patient feels well, he should not neglect the prescribed examination, during which the doctor:

using special programs will check the performance of the CS;
check the battery charge;
if necessary, he will make adjustments to its settings.

The inspection usually takes no more than 20 minutes.

Battery replacement is usually performed under local anesthesia. Sometimes it is necessary to change the electrodes or completely replace the pacemaker. In this case, general anesthesia may be required.

When is the right time to contact your doctor?

The following situations are reasons to consult a doctor earlier scheduled period for regular inspections:

if your heart rate is below the minimum set on your device;
when swelling, redness or discharge appears in the area where the CS is installed;
questions have arisen related to the operation of the pacemaker or taking medications;
any unusual, previously unoccurring change in health status (for example, new symptoms).

But there may be other reasons. Usually, upon discharge, the doctor describes situations when it is necessary to urgently contact him.

A pacemaker is placed to prevent or correct a problem, not create one. If you constantly follow certain precautions that are not so burdensome, and follow the instructions of your doctor, then problems will not arise. This allows you to lead a normal lifestyle, devoid of any practical restrictions.

cardiobook.ru

The doctor is always aware of the work of your heart

In 2009, a revolutionary event for cardio medicine took place. For the first time, the patient was implanted with a pacemaker from the German manufacturer Biotronik with a system for recording and transmitting data on the work of the patient’s heart muscle to the attending physician. Information about the functioning of the heart is collected in a continuous monitoring mode, which makes it possible to record minimal deviations in the functioning of the heart muscle. The doctor receives information through a special application on his mobile phone. A significant part of the measurements carried out by the German brand Biotronik ECS were previously carried out only in equipped clinical centers. The mobility of the diagnostic procedure, coupled with its implementation under constant monitoring, has opened up new opportunities for European medicine to preserve human life.

Installation of tracking pacemakers can be carried out at the German cardiology clinic Delius Praxis. Installation of a modern pacemaker allows you to neutralize the risks of sudden death, which has a positive effect on the statistics of life expectancy with a pacemaker.

A pacemaker can save a life from an accident.

Many people are aware of the minor restrictions that people wearing pacemakers experience: avoid the magnetic frames of detectors, do not use firearms, do not scuba dive, do not engage in contact fighting.

But there is also the other side of the coin. A pacemaker can prevent cardiac arrest during fatal hypothermia. There are known cases when climbers, travelers, people who had accidents survived despite the extremely low temperatures with which their bodies struggled. The pacemaker of the survivors did not allow the heart to stop, allowing them to survive a situation in which a person without a pacemaker would have had less chance.

Answering the main question

And still. How long do patients live with a pacemaker? Life expectancy is not at all limited by this factor. We will only note that at the Delius clinic there are patients for whom ECS has been prolonging their lives every second for three decades. And note that these patients have a busy and active life. Modern pacemakers are well protected even from MRI radiation, they are reliable, trouble-free and do not allow pathological changes to develop without the knowledge of the doctor and the patient.

delius-praxis.ru

1Excursion into history

In less than 70 years since the development of the first portable pacemaker, the pacing industry has made enormous strides in its development. The late 50s and early 60s of the 20th century were the “golden years” of cardiac stimulation, since during these years a portable pacemaker was developed and the first cardiac pacemaker was implanted. The first portable device was large in size and also depended on external electricity. This was its huge disadvantage - it was connected to an outlet, and if there were power outages, the device immediately turned off.

In 1957, a 3-hour power outage led to the death of a child with a pacemaker. It was obvious that the device required improvement, and within a few years scientists developed a completely portable portable stimulator that was attached to the human body. In 1958, a pacemaker was implanted for the first time; the device itself was located in the abdominal wall, and the electrodes directly in the heart muscle.

Every decade, the electrodes and the “filling” of the devices, their appearance, were improved: in the 70s, a lithium battery was created, due to which the service life of the devices was significantly increased, dual-chamber pacemakers were created, which made it possible to stimulate all cardiac chambers - both the atria and ventricles . In the 1990s, ECS with a microprocessor were created. It became possible to store information about the rhythm and frequency of contractions of the patient’s heart; the stimulator not only “set” the rhythm itself, but could adapt to the human body, only by adjusting cardiac work.

The 2000s were marked by a new discovery - biventricular stimulation in severe heart failure became possible. This discovery significantly improved cardiac contractility as well as patient survival. In short, from the mid-twentieth century to the present day, the pacemaker has gone through many stages in its development, thanks to the discoveries of doctors, scientists, and physicists. Thanks to their discoveries, millions of people today live more fulfilling and happier lives.

2Design of a modern device

A pacemaker is also called an artificial pacemaker, because it is the one that “sets” the pace of the heart. How does a modern heart pacemaker work? Main elements of the device:

Chip. This is the “brain” of the device. It is here that impulses are generated, cardiac activity is controlled, and cardiac arrhythmias are promptly corrected. Devices have been developed that work regularly, “imposing” a certain rhythm of contractions on the heart, or work “on demand”: when the heart contracts normally, the pacemaker is inactive, and as soon as the heart rhythm is disturbed, the device starts working.
Battery. Any brain needs power, and the microcircuit needs energy generated by the battery, which is located inside the device body. Battery depletion does not occur suddenly; the device checks its operation every 11 hours automatically, and also provides information on how long the pacemaker can last. This allows you, while the device is still operating normally, when the time is approaching, to think about replacing it.
If the doctor talks about the need to replace the devices, then, as a rule, it can still work normally for more than one month. Today, EX batteries are lithium, their service life is 8-10 years. But it is not always possible to say exactly how long a pacemaker will operate in a particular case; this indicator is individual, and its duration depends on the stimulation parameters and other factors.
Electrodes. They establish a connection between the device and the heart and are attached through vessels in the cardiac cavities. Electrodes are special conductors of impulses from the device to the heart; they also carry information in the opposite direction: about the activity of the heart to the artificial pacemaker. If the pacemaker has one electrode, then such a stimulator is called single-chamber; it can generate an impulse in one cardiac chamber - the atrium or ventricle. If two electrodes are connected to the device, then we are dealing with a two-chamber pacemaker that can generate impulses simultaneously in both the upper and lower cardiac chambers. There are also three-chamber devices, with three electrodes, respectively; most often this type of pacemaker is used for heart failure.

3Who is the installation shown to?

When does a person need to have an artificial pacemaker installed? In cases where the patient’s heart is not able to independently produce impulses at the required frequency in order to ensure full contractile activity and normal heart rhythm. Indications for installing a pacemaker are the following conditions:

A decrease in heart rate to 40 or less with clinical symptoms: dizziness, loss of consciousness.
Severe heart block and conduction disturbances
Attacks of paroxysmal tachycardia that cannot be treated with medication
Episodes of asystole longer than 3 seconds recorded on the cardiogram
Severe ventricular tachycardia, life-threatening fibrillation, resistant to drug therapy
Severe manifestations of heart failure.

Most often, the stimulator is installed for bradyarrhythmias, when the patient develops blockades - conduction disturbances - against the background of a low pulse. Such conditions are often accompanied by clinical episodes of Morgani-Adams-Stokes. With such an attack, the patient suddenly turns pale and loses consciousness; he remains unconscious for 2 seconds to 1 minute, less often for 2 minutes. Fainting is associated with a sharp decrease in blood flow due to disruption of the heart. Usually, consciousness after an attack is completely restored, the neurological status does not suffer, the patient, after the attack resolves, feels slightly weak and tired. Any arrhythmias accompanied by such a clinic are an indication for installing an pacemaker.

4Operation and life after it

Currently, the operation is performed under local anesthesia. An anesthetic is injected into the skin and underlying tissues, a small incision is made in the subclavian area and the doctor inserts electrodes into the heart chamber through the subclavian vein. The device itself is implanted under the collarbone. The electrodes are connected to the device, and the required mode is set. Today there are many stimulation modes; the device can work constantly and “impose” its fixed rhythm on the heart, or turn on “on demand”.

The “demand” mode is popular for frequently recurring attacks of loss of consciousness. The stimulator works when the spontaneous heart rate falls below the level specified by the program; if the “native” heart rate is higher than this level of heart rate, the pacemaker turns off. Complications after surgery are rare; they occur in 3-4% of cases. Thrombosis, infections in the wound, fractures of the electrodes, disruptions in their operation, as well as malfunctions of the device may occur.

To prevent the development of complications after pacemaker implantation, patients should be monitored by a cardiologist, as well as by a cardiac surgeon 1-2 times a year, and ECG monitoring is necessary. About 1.5 months are required for reliable encapsulation of the electrode head in tissue, about 2 months are required for the patient’s psychological adaptation to the device.

It is allowed to start working after surgery after 5-8 weeks, not earlier. Patients with a heart pacemaker are contraindicated from working in conditions of magnetic fields, microwave fields, working with electrolytes, in conditions of vibration, and significant physical activity. Such patients should not undergo MRI, use physiotherapeutic treatment methods so as not to disrupt the operation of the device, linger for a long time near metal detectors, or place a mobile phone in close proximity to the stimulator.

You can talk on a mobile phone, but place it near your ear on the side opposite from the one on which the stimulator is implanted. Watching TV, using an electric razor, or using a microwave oven is not prohibited, but you must be at a distance of 15-30 cm from the source. In general, if you do not take into account minor restrictions, life with a pacemaker is not much different from the life of an ordinary person.

5When is a pacemaker prohibited?

There are no absolute contraindications to pacemaker installation. Today, there are no age restrictions for surgery, as well as any diseases for which pacemaker placement is not possible; patients, even with an acute heart attack, can have a pacemaker installed according to indications. Sometimes implantation of the device can be delayed if necessary. For example, during exacerbation of chronic diseases (asthma, bronchitis, stomach ulcer), acute infectious diseases, fever. In such conditions, the risk of complications after surgery increases.

More than three hundred thousand permanent pacemakers (pacers) are installed around the world each year because patients with some severe heart lesions require an artificial pacemaker.

Types of pacemakers

There are different types of heart pacemakers:

single-chamber, which are capable of stimulating only one chamber - the ventricle or atrium;
dual-chamber, which can stimulate two cardiac chambers: both the ventricle and the atrium;
Three-chamber pacemakers are required for patients with heart failure, as well as in the presence of ventricular fibrillation, ventricular tachycardia and other life-threatening types of arrhythmias.

Indications for installation of a pacemaker

Absolute indications for a pacemaker

Absolute indications are:

bradycardia with pronounced clinical symptoms - dizziness, syncope, Morgagni-Adams-Stokes syndrome (MAS);
episodes of asystole lasting more than three seconds, recorded on the ECG;
if during physical activity the heart rate is recorded below 40 per minute;
when persistent atrioventricular block of the second or third degree is combined with two-bundle or three-bundle blockades;
if the same blockade occurs after myocardial infarction and manifests itself clinically.

Relative indications for pacemaker

The relative indications for a permanently implanted pacemaker are as follows:

if third-degree atrioventricular block occurs at any anatomical site with a heart rate under a load of more than 40 beats, which is not clinically manifested;
the presence of atrioventricular block of the second type and second degree without clinical manifestations;
syncope in patients against the background of two- and three-fascicular blockades, not accompanied by ventricular tachycardia or transverse block, while it is not possible to establish other causes of syncope.

When is the installation of a pacemaker not justified?

In fact, a pacemaker has no contraindications for its installation, except in the case of its unjustified implantation.

Such insufficient grounds for implantation are:

first degree atrioventricular block without clinical manifestations;
proximal atrioventricular block of the first type of the second degree, without clinical manifestations;
atrioventricular block that can regress (for example, caused by medication).

a single-chamber pacemaker will require half an hour;
for a two-chamber pacemaker – 1 hour;
A three-chamber pacemaker requires 2.5 hours to install.

Typically, surgery to install a pacemaker occurs under local anesthesia.

The operation to implant an pacemaker consists of the following steps:

Preparing for surgery. This includes debridement of the surgical site and local anesthesia. An anesthetic drug (novocaine, trimecaine, lidocaine) is injected into the skin and underlying tissues.
Installation of electrodes. The surgeon makes a small incision in the subclavian region. Next, the electrodes under X-ray control are inserted sequentially through the subclavian vein into the desired cardiac chamber.
Implantation of the pacemaker housing. The device body is implanted under the collarbone, and it can be installed subcutaneously or deepened under the pectoral muscle.

In our country, the device is more often implanted in right-handed people on the left, and in left-handed people on the right, which makes it easier for them to use the device.

The electrodes are connected to the already implanted device.
Device programming. It is produced individually to suit the patient’s needs, taking into account the clinical situation and the capabilities of the device (which also determine the cost of the pacemaker). In modern devices, the doctor can set the basic heart rate, both for the state of physical activity and for rest.

Essentially, this is all the basic information about how a pacemaker is installed.

Complications after pacemaker installation

It is worth knowing that complications after installing a pacemaker occur in no more than 3-5% of cases, so you should not be afraid of this operation.

Early postoperative complications:

violation of the tightness of the pleural cavity (pneumothorax);
thromboembolism;
bleeding;
violation of insulation, displacement, fracture of the electrode;
infection of the surgical wound area.

Long-term complications:

EX syndrome - shortness of breath, dizziness, decreased blood pressure, episodic loss of consciousness;
pacemaker-induced tachycardia;
premature failures in the ECS.

If there are complaints about deterioration in health, the patient should immediately consult with the attending physician.

What can and cannot be done if you have a pacemaker?

Living with a heart pacemaker imposes the following restrictions on a person:

undergo an MRI;
engage in hazardous sports;
climb high-voltage power lines;
approach transformer booths;
put a mobile phone in your breast pocket;
stay close to metal detectors for a long time;
undergo shock wave lithotripsy without preliminary adjustment of the pacemaker or perform electrocoagulation of tissues during surgery.

Cost of installing a pacemaker

Basically, since pacemaker implantation is paid for by the compulsory medical insurance fund, the cost of installing a pacemaker is usually zero.

But sometimes patients themselves pay for it and additional services (this applies to foreigners and people who do not have compulsory medical insurance).

The following prices apply in Russia:

implantation of a pacemaker – from 100 to 650 thousand rubles;
implantation of electrodes – minimum 2000 rubles;
surgical manipulations – from 7,500 rubles;
Staying in the ward costs at least 2,000 rubles per day.

The overall cost is most influenced by the ECS model and the prices of the selected clinic. For example, in a provincial cardiology center, simple implantation of an outdated domestic pacemaker model can cost at least 25,000 rubles. In large vascular clinics that use modern imported devices and provide additional services, the cost jumps to 300 thousand rubles.

How to behave after installing a pacemaker?

First postoperative week

The postoperative wound should be kept clean and dry according to the recommendations of the medical staff.
If the early postoperative period is favorable, five days after surgery it is already permissible to take a shower, and a week later most patients return to their usual work schedule.
To prevent the seams from coming apart, you should not lift more than 5 kg for the first time.
You cannot do heavy housework, but when doing lighter work, you need to listen to how you are feeling and immediately put off work if any unpleasant sensations appear. You can't force yourself.

One month after surgery

Exercising after having a pacemaker installed is not only useful, but also necessary. Long walks are beneficial. But tennis, swimming pool and other strenuous sports will have to be postponed for a while. Over time, the doctor monitoring the patient's health may remove some restrictions regarding sports.
You need to visit the doctor according to plan: after 3 months - the first examination, after six months - the second, and then every six months or a year.

If a person feels discomfort or anxiety about the operation of the pacemaker, then they should consult a doctor immediately.

Life after pacemaker implantation

Electrical devices. Although pacemakers are equipped with protection against interference from other electrical devices, strong electric fields should still be avoided. The use of almost all household appliances is allowed: TV, radio, refrigerator, tape recorder, microwave oven, computer, electric razor, hair dryer, washing machine. To avoid interference, you should not approach the pacemaker implantation site closer than 10 cm to an electrical appliance, lean against the front wall of the microwave (and generally avoid it) or the screen of a working TV. You should stay away from welding equipment, electric steelmaking furnaces, and high-voltage power lines. It is not advisable to go through control turnstiles in shops, airports, and museums. In this case, upon discharge from the hospital, the patient is given a device passport and an owner’s card, which must be presented during the search, after which it can be replaced by a personal search. The KS is also not afraid of most office equipment. It is advisable to develop the habit of grasping appliance plugs and other voltage sources with the hand further away from the pacemaker.
Mobile phone. Long conversations on it are undesirable, and you need to hold the receiver 30 cm or more from the CS. When talking, hold the tube to the ear on the opposite side of the implantation site. Do not carry the handset in your breast pocket or around your neck.
Sport. It is prohibited to engage in contact and traumatic sports, that is, team sports, martial arts, since any blow to the abdominal cavity or chest can damage the device. For the same reason, shooting with a gun is not recommended. With a pacemaker, you can return to walking, swimming and such physical exercises that allow constant monitoring of your well-being and allow you to follow safety rules.

Validity period and how long do people live with a pacemaker?

In other words, having a pacemaker can only prolong life, not make it shorter.

Have you already had a pacemaker installed? Or do you still have to undergo this operation? Tell your story and feelings in the comments, share your experience with others.

When is a pacemaker placed?

Indications for installing a pacemaker are:

all types when the heart rate is less than 60 per minute;
atrioventricular blockade.

There are practically no contraindications to implantation of a heart pacemaker, but there are a number of factors that increase the risk of complications, including:

violations;
overweight;
smoking and excessive alcohol consumption;
regular use of certain medications.

Surgery to install a pacemaker

Preparation for surgery includes:

blood tests;
performing a chest x-ray;
taking an electrocardiogram.

Rehabilitation after installation of a pacemaker

You can return to your normal lifestyle 2 weeks after implantation.
You are allowed to drive a car no earlier than 1 week after discharge from the hospital.
Significant physical activity should be avoided for 6 weeks.

During the rest of your life with an implanted pacemaker, you should avoid interaction with:

radio and television transmitters;
high-voltage equipment;
radar installations.

You must not undergo medical or examination procedures, such as:

Magnetic resonance imaging;
thermal physiotherapy.

Doctors also do not recommend carrying a mobile phone in a pocket near the heart. It is not advisable to use an MP3 player and headphones. Caution should be exercised when passing through security detectors at airports and similar locations. In order not to undergo a procedure hazardous to health, you must have the card of the owner of the device with you. It is necessary to notify a doctor of any specialty about the presence of a pacemaker. who had to seek medical help. The service life of a heart pacemaker is from 7 to 15 years; after this time, the device is replaced.

How long do people live with a pacemaker?

For those who are recommended to have surgery to install the device, this issue is especially significant. As medical practice shows, if the doctor’s recommendations are followed, patients with an implant in the heart live as long as other people live, that is, we can say with confidence: a pacemaker does not affect life expectancy.

Heart pathology is extremely common. This is not only angina pectoris, heart attacks, hypertrophy of its parts, but also serious rhythm disturbances that occur even with minimal structural changes in the organ, are difficult to treat with medication and can lead to death. In such cases, installing a pacemaker (pacemaker, CS, pacemaker) is the only way to preserve both the health and life of the patient.

Various types of arrhythmias lead to disruption of blood movement through the chambers of the heart and blood vessels of the body, and bradycardia, blockades, and dysfunction of pacemakers are especially dangerous, since the absence of impulses will cause the absence of contractions of the heart chambers, and its complete stop is possible.

Arrhythmias can occur spontaneously, without obvious morphological changes in the heart, and genetic mechanisms for these anomalies cannot be excluded. In some cases, they accompany another pathology - defects, coronary artery disease, cardiomyopathies, etc.

The need to install a pacemaker occurs when the heart rate is critically low, when the required number of electrical impulses does not reach the heart muscle. Indications are determined by a cardiologist after a detailed examination of the patient.

Every year, more than 300 thousand devices that stimulate the myocardium are installed in the world. Operations are literally “put on stream” in cardiology centers, whose personnel have extensive experience in performing these manipulations. After treatment, patients return to their normal lives, manifestations of arrhythmia are eliminated, significantly improving their well-being.

The installation of a pacemaker is considered a relatively safe procedure, so there are not many contraindications to it, and despite the apparent simplicity of both the device itself and its implantation, it is very effective and, without exaggeration, saves millions of lives of cardiac patients.

Indications and contraindications for pacemaker implantation

Indications for installing a pacemaker are those types of arrhythmias in which the heart rate (HR) is unacceptably low. Rare contractions of the heart, long intervals between them, “loss” of individual heartbeats, low activity of pacemakers create a threat of acute heart failure, the most dangerous consequence of which can be the death of the patient. These phenomena can occur suddenly - at work, at home, on the street, so preventing complications and restoring an acceptable rhythm is the main goal of installing an artificial heart stimulator.

Indications for surgery can be absolute and relative. The first group includes:

Severe bradycardia, manifested by a number of symptoms (fainting, dizziness, syncope);
Pulse less than 40 heart beats per minute during physical activity;
Periods of cardiac arrest for 3 seconds or more, recorded on the ECG;
Persistent AV block, starting from the second degree, especially in combination with difficulty conducting through all three bundles of the conduction system, after cardiac infarction;
Any type of bradycardia when the heart rate falls below 60 beats per minute.

The latter occurs without anesthesia and incisions by attaching a special reading device to the device - a programmer, which allows the doctor to change the set parameters if necessary. The reasons for an unscheduled visit to a doctor are:

Episodes of loss of consciousness, including during stereotypical movements (raising an arm, turning the head)
The appearance of a rare pulse (less than the minimum set frequency of the device)
Twitching of the muscles of the stimulator bed with a frequency programmed in the pacemaker memory (cause - violation of the electrode insulation)
Impact at the location where the device is installed (fall, deployment of airbags in a car)
Electric shock

The pacemaker is designed solely to correct the patient's rhythm. The functioning of the device in the body does not in any way affect the level and frequency of arrhythmia attacks that the patient may have had previously or appeared after installation.

If the parameters are satisfactory, after the first check the patient is allowed to sleep in any position, lift up to five kilograms with his left hand, and drive a car. The possibility of returning to work and the timing are determined by a medical commission.

After installing the device in your home, you can use all appliances (working!): washing machine, dishwasher, microwave oven, TV, cell phone and radiotelephone, electric toothbrush, electric razor, hair clipper, hair dryer and others.

When going through metal detectors in stores, show your implanted device patient card. It is not recommended to go through pre-flight controls at the airport (present your patient card).

All sports are allowed, with the exception of those involving heavy lifting; team games with caution (it is necessary to protect the pacemaker from direct impact).

Drinking alcohol and coughing do not affect the functioning of the device.

You cannot engage in boxing, hand-to-hand combat and other martial arts, any types of wrestling, football, rugby, basketball, hockey, parachute jumping, etc. It is also undesirable to engage in shooting.

Exercises on the pectoral muscles using weights are prohibited in the gym.

Use of household appliances, electronics, tools

There are no risks associated with the correct use of the following devices:

Fridge.
Dishwasher.
Electronic balance.
Ionizing air filters, air humidifiers, automatic fragrances.
Hair curling irons and straightening irons.
Calculator.
Battery-powered flashlight, laser pointer.
Printer, fax, scanner, copier.
Barcode Scanner.

The use of other devices is also permitted. The only rule is to maintain the required distance between the device and the pacemaker.

Read more about the distance in the table.

Minimum distance to pacemaker	List of devices
20 cm	Remote control for TV and other devices, hair dryer, sewing machine, vacuum cleaner, massager, mixer, electric knife, electric razor, electric toothbrush, control panel on an exercise bike, treadmill, mobile phone, laptop, circular saw, screwdriver, soldering iron, meat grinder, gaming set-top boxes, Wi-Fi routers, modems, Bluetooth headsets, radios, music and video players, electric guitar, TV, PC.
31 cm	Motorcycle and car ignition systems, boat engines, car battery, lawn mower, chainsaw, snow blower, induction cooktop, microwave oven.
61 cm	Welding equipment up to 160 amperes.

It is prohibited to use or be closer than 2.5 m from welding equipment over 160 amperes.

Limitations in professional activities

Contraindicated professions:

loader;
electrician;
electrician;
welder.

There are no restrictions on working with a computer.

If the pacemaker was installed due to severe heart failure, it is possible to assign disability groups 3–2.

Prohibited medical procedures

Patients with installed pacemaker should not undergo:

MRI (however, there are some models of stimulators that allow you to undergo MRI - check with the doctor who installed the device for you);
Physiotherapeutic and cosmetic procedures using electric, magnetic and other types of radiation. These are electrophoresis, diathermy, heating, magnetic therapy, transcutaneous electrical nerve stimulation, etc. You can check with your doctor for the full list.
Ultrasound with the beam directed directly at the device.

Before having any medical procedures or surgery, tell your doctor that you have a pacemaker.

Forecast: service life, efficiency

The warranty period for pacemakers ranges from 3 to 5 years, depending on the manufacturer. The service life for which the device’s battery is designed is 8–10 years. After the battery is discharged or the device fails, the pacemaker will need to be replaced.

Often the electrodes passed to the heart are still in good condition. In such cases, they are not touched, but only the main part of the device is replaced - the electrical pulse generator. If the device fails before the expiration of the warranty period, a free replacement under warranty is possible, except in cases where the device broke down due to your fault.

A pacemaker is a small device that helps control heart rhythms. The main indication for its installation is rapid or slow heartbeat, which does not respond to conservative treatment. The device is implanted in, under the right or left collarbone. Electrical impulses sent by the device cause the heart to beat at a normal pace. What else do you need to know about this device before implantation?

Types of pacemakers

Temporary. It is established for a certain period until the ailments completely disappear. Used in cases of slow heart rate caused by a heart attack. After the operation, the patient remains in the hospital under the supervision of doctors all the time. Then a decision is made to remove the device or replace it with a permanent one.

Constant. Installed for a long period until replacement is required.

Indications for installing a pacemaker

An artificial pacemaker (pacemaker) is installed for any manifestations of arrhythmia. With this pathology, the beat frequency can be high (tachycardia) or low (bradycardia). Such deviations cause a number of symptoms:

dizziness;
fatigue;
frequent loss of consciousness;
dyspnea.

If drug treatment does not help to adjust the heart rate, then decisions are made to install a pacemaker.

Besides, A pacemaker is installed when:

congenital cardiac diseases;
heart block;
heart transplant.

Before scheduling an operation, you will need to undergo a number of examinations:

electrocardiogram (ECG);
daily (Holter) monitoring. A portable ECG device is attached to the patient's body. After 24-48 hours, the device is removed and the results are deciphered;
ultrasound examination (ultrasound);
electrophysiological study (EPS). Used to detect cardiac muscle activity;
stress test. This makes it possible to identify ailments that appear only in stressful situations, during physical activity.

Pacemaker installation

A pacemaker is a small metal box containing a battery, a computerized sensor, and wires.

The procedure is performed under local anesthesia. First, the surgeon numbs the area under the collarbone, then punctures a vein through which he passes electrodes to the heart. When the wires are tightly fixed, the wound is sutured. The operation lasts about 30 minutes.

After the procedure, doctors monitor pulse and blood pressure. They remain under observation from a week to a month. The length of inpatient stay depends on each individual case.

Complications after pacemaker installation

Often, stimulator implantation is well tolerated by patients. But sometimes there are:

pain at the incision site;
severe swelling;
minor bleeding.

Life with a pacemaker

They come for the first examination three months after discharge from the hospital. The next visit is scheduled in six months. If your health does not worsen, then further examinations are carried out once a year.

People who have a pacemaker are contraindicated:

conduct magnetic resonance imaging (MRI);
be near television towers;
go through metal detectors in stores and airports;
do excessive exercise. Swimming is permitted.

Do I need to replace my pacemaker?

The pacemaker is powered by a battery, which gradually discharges. Depending on the type of device, charging may last for 7 years. Modern devices are programmed in such a way that they turn on only when necessary. With a normal heart rhythm, the mechanism does not function. This feature of the device helps extend its service life up to 12 years.

The patient does not have to worry that the pacemaker will suddenly fail. Malfunctions in the operation of the mini-device usually manifest themselves gradually in the form of a deterioration in general well-being.

If you feel any discomfort, immediately consult a doctor. The specialist will conduct an additional test and determine the advisability of changing the stimulant.

How much does a pacemaker cost?

The cost of a pacemaker depends on the manufacturer and year of manufacture. The highest price is for foreign new products, and the lowest for domestic outdated models. There are three price categories:

1. The most expensive. This group includes imported pacemakers. They are of high quality and have many supporting functions. You will have to pay about $3,500 for the stimulator.

2. Average price. The advantage of modern models from domestic manufacturers is the cost - from 800 to 1200 $. The disadvantage is the short service life, which is no more than three years.

3. Cheap. Outdated samples can be purchased for $500. But this is their only advantage.

Medicine does not stand still; new medicines and devices are constantly appearing that can extend human life. Heart disease remained incurable for several decades. But now cardiologists have the opportunity not only to “look” into the heart, to see how it works inside, but to make it work. The heart pacemaker became a real salvation; doctors and patients always received only positive feedback.

The device consists of the main elements:

Titanium case.
Connector block.
Electrodes.
Programmer.

batteries
microcircuits

The purpose of batteries is to produce the energy needed to create electrical impulses.

Microcircuits make it possible not only to obtain, but also to monitor electrodynamics.

The connection block is used to connect the electrodes and the housing. Electrodes are placed in the heart muscle, which allows information to be read. Carrying electrical charges help the heart muscle contract properly.

The programmer or computer is located in the medical institution where the operation to install the device was performed. Its role is to set or change pacemaker settings if necessary.

Installation of the device

Many people are interested in how the device installation process occurs. considered simple. The patient is prepared in advance, the necessary examinations are carried out. The process does not take long.

The essence of the procedure:

insert a special device into the subcutaneous fat tissue
place electrodes in various areas of the heart muscle

The operation is performed under local anesthesia. The following is done:

The patient makes an incision in the collarbone area.
Electrodes are inserted through a thin vein.
The device is connected to the heart.

Important! Despite the fact that the procedure is simple, all work on installing a pacemaker is carried out using special X-ray equipment.

After installing the device, people's lives change, new requirements appear, and some restrictions arise. But you can get used to everything. We must remember that the heart remains the same and must be protected.

The first days after installing the device

In the first days you need to adhere to the following:

monitor the postoperative wound to keep it clean and dry
if the person’s condition is good, there are no complications, then on the fifth day you can safely take a shower
Do not lift weights in the first week
Avoid heavy physical work around the house, such as snow removal

Most people return to work within a week after surgery.

We must remember! No matter how well you feel after installing a pacemaker, you must listen to your body. If you feel tired, you need to put things aside and rest a little.

Life a month after the device was installed

After a month, a person who has undergone surgery is allowed. But there can be no talk of heavy physical activity. Swimming, playing tennis and golf are allowed. Walking is especially useful.

If you experience anxiety or discomfort, you should consult a doctor immediately.

How to live on after having a pacemaker installed. Recommendations

Despite the fact that the device is equipped with special built-in protection from the influence and interference of other electrical devices, you still need to avoid powerful electric fields. Do not be afraid of household appliances such as: microwave oven, tape recorder, vacuum cleaner, refrigerator, computer and the like.

It must be remembered that in order to prevent interference, the devices must be located at a distance of no closer than a decimeter from the area where the cardiac device is installed.

There are a number of rules that must be followed in everyday life:

Do not touch the area where the cardiac device is installed to the operating TV.
Do not lean against the front wall of the microwave oven.
Do not stay near high-voltage power lines.
Do not stand near welding equipment.
Stay away from electric steel furnaces.

If such things as radiation therapy, diathermy, magnetic resonance diagnostics, external defibrillation are prescribed, then first of all you need to inform the doctors that you have a pacemaker installed.

Fluorography and x-rays are not contraindicated. Sometimes radiography is prescribed if there is the slightest suspicion of electrode failure.

Important! You should not sunbathe in the open rays of the sun. In hot weather, you should always wear cotton clothing on your body.

Is it possible to live with a disabled pacemaker? How long do people live with a pacemaker?

Basic information

Installation of the device

The first days after installing the device

Life a month after the device was installed

How to live on after having a pacemaker installed. Recommendations

Reviews about the pacemaker

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Pacemaker: what are the contraindications after its installation?

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Installation of a pacemaker: do's and don'ts?

First 7 days after implantation

First month after implantation

How to live after having a pacemaker installed?

Life expectancy after pacemaker installation

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How long do people live with a pacemaker?

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Life expectancy with a pacemaker

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Types of pacemakers

Indications for installation of a pacemaker

Absolute indications for a pacemaker

Relative indications for pacemaker

When is the installation of a pacemaker not justified?

How is a pacemaker placed?

Complications after pacemaker installation

What can and cannot be done if you have a pacemaker?

Cost of installing a pacemaker

How to behave after installing a pacemaker?

First postoperative week

One month after surgery

Life after pacemaker implantation

Validity period and how long do people live with a pacemaker?

When is a pacemaker placed?

Rehabilitation after installation of a pacemaker

Operating principle of the device and indications for implantation

Sequence of actions when installing a pacemaker

Basic laws of life with a pacemaker

Sports activities with an artificial pacemaker

What to watch out for at home

Types of pacemakers

Useful video

Risks associated with the operation

Recovery after surgery

Life with a pacemaker: on the street and at home, medical procedures

Physical activity and sports

Regular checkups

When is the right time to contact your doctor?

The doctor is always aware of the work of your heart

A pacemaker can save a life from an accident.

Answering the main question

1Excursion into history

2Design of a modern device

3Who is the installation shown to?

4Operation and life after it

5When is a pacemaker prohibited?

Types of pacemakers

Indications for installation of a pacemaker

Absolute indications for a pacemaker

Relative indications for pacemaker

When is the installation of a pacemaker not justified?

Complications after pacemaker installation

What can and cannot be done if you have a pacemaker?

Cost of installing a pacemaker

How to behave after installing a pacemaker?

First postoperative week

One month after surgery

Life after pacemaker implantation

Validity period and how long do people live with a pacemaker?

When is a pacemaker placed?

Rehabilitation after installation of a pacemaker

How long do people live with a pacemaker?

Indications and contraindications for pacemaker implantation

Use of household appliances, electronics, tools