Heart pacemaker: contraindications. Rules of conduct for a patient with a pacemaker
Cardiovascular diseases are the most common in the world. The most dangerous are the consequences of improper treatment of hypertension. Develop a stroke or heart attack, which have a very high mortality rate.
The occurrence of such terrible consequences is far from the last role played by arrhythmia. Incorrect asynchronous contraction of the cardiac muscle not only leads to a decrease in the blood filling of vital organs, but also provokes the formation of blood clots. Patients with dangerous forms of arrhythmias are usually treated with a variety of pharmaceuticals, but a pacemaker is a fairly effective and reliable option for their relief. Any center of modern cardiology in Russia conducts operations to install it.
What is a pacemaker?
A pacemaker is an electronic device that is designed to monitor and correct heart function. The device itself consists of a regular battery and several electrodes, which are supplied to the heart muscle. The essence of the pacemaker work is to identify arrhythmia and its correction due to electrical signals that reach the heart. The electromagnetic stimulus affects the heart muscle and causes the wrong rhythm to "switch" to the right one. Therefore, an established cardiac pacemaker will help effectively eliminate dangerous arrhythmia. There are no contraindications to its implantation.
What are the types of pacemakers
The separation of devices is based on the number of chambers of the heart, to which the electrodes from the device are suitable. Therefore, almost every cardiac surgeon will offer you a one-, two- or three-chamber pacemaker. The photo reflects the appearance of a single-chamber device that has only one electrode. It is usually located in the ventricle. Such models are now practically not used, which is due to the limited range of the action of electric charge. The two-chamber device has one electrode in the atrium, and the other - in the ventricle, which provides both better monitoring and correction of the heart. Such devices are used more often. The three-chamber pacemaker has three electrodes, one of which can perform the function of a defibrillator, which is especially desirable for patients with atrial fibrillation or ventricles. The cost of a pacemaker depends on the manufacturer's firm and the price policy of the medical institution.
When installing a pacemaker
Implantation of the pacemaker is aimed at restoring the right rhythm. To fight brady- and tachyarrhythmias, a cardiac pacemaker is installed. The operation is applied only in the presence of certain types of arrhythmia. In particular, bradyarrhythmias include bradycardia with a pulse rate less than 40 beats per minute, Morgagni-Edessa-Stokes syndrome, grade II-III AV blockade, incomplete blockade, sinus node weakness syndrome, and carotid sinus syndrome. Morgagni-Edessa-Stokes syndrome is manifested by loss of consciousness, convulsions, which is associated with complete AV blockade. As for tachyarrhythmias, the indications are atrial fibrillation and rhythm disturbances that are associated with the physician.
The Center for Contemporary Cardiology can offer you the establishment of a pacemaker on a temporary or permanent basis. Temporary implantation of the device is rarely used and serves to correct certain types of arrhythmias (eg paroxysmal tachyarrhythmia).
Heart pacemaker, contraindications
Installation of a pacemaker has no contraindications. The only caveat is the validity of the device installation, which depends both on the life expectancy of the patient with arrhythmia and the shape of the cardiac arrhythmia. Before the implantation of the pacemaker, the patient must undergo Holter monitoring. This is a round-the-clock observation and analysis of the rhythm and heart rate, which allows you to find out the type of arrhythmia and when it most often occurs.
How the pacemaker is implanted
The operation is considered to be minimally invasive, since it is made from small incisions. First, the surgeon inserts a catheter into the subclavian vein and, under the control of the x-rays, sets the electrodes in the desired area of the heart. After the introduction of sensors into the formed bed in the projection of the large pectoral muscle a cardiac pacemaker is installed. The operation ends with the imposition of several stitches on the skin.
After that, the device starts to work and generates pulses depending on the correct rhythm. Maximally reduce the likelihood of arrhythmias will help cardiac pacemakers, which are not contraindicated.
Patient's life after surgery
Life with a pacemaker imposes certain limitations on the patient, which, although not serious, however, are important for the correct and long-term operation of the device.
First of all, one should remember about the methods of examination of the body, the principle of which is based on the action of an electromagnetic field or current. It is recommended to use computed tomography or ultrasound for a patient who has a cardiac pacemaker. Contraindications include magnetic resonance imaging and external defibrillation, lithotripsy and radiation therapy. When conducting echocardiography, the doctor should be warned about the installed device, since a direct hit can cause interruptions.
Each patient is given a specific document-passport of the patient to whom the pacemaker is implanted. This document contains information on the model of the installed apparatus, the date of implantation and the approximate period of the replacement of the battery. For persons who travel abroad, such documentation will be required when passing customs control at airports.
The dosage of the goods must be gradual, however regular. During the first month, light homework, morning hygienic gymnastics, small walks in the fresh air are recommended. In the future, the regime for increasing tolerance to loads is gradually expanding. If the patient before the operation was engaged in swimming or tennis, then approximately six months later, he can gradually restore his level of employment. At the same time, it is necessary to observe the heart rhythm and arterial pressure. If you notice interruptions, shortness of breath, dizziness, or general weakness - consult your doctor.
Postoperative wound and observation of it
The most important period is the first 7 days after the operation. it
first of all, the condition of the postoperative wound. The first 5-7 days of the patient is in the hospital to monitor the work of the electrostimulator. Every day a wound dressing and toilet is performed. The stitches are removed on 6-th - 7-th day. After the seams have been removed, the patient has to limit the load on the upper limb for 7 days from the location of the implanted device. Such activities are carried out with the aim of creating a mature rumen that can withstand the usual work.
For patients, this diet is prescribed, as in atherosclerosis. Diet № 10 recommends restriction of animal fats, replacing them with vegetable oils (sunflower, linseed, olive), a diet that is enriched with fiber and proteins of plant origin. It is undesirable to use rich broths, salted varieties of meat and fish, and to limit flour dishes. Also, you should limit the intake of coffee and strong tea, since these drinks are stimulants of the nervous system and can provoke arrhythmias. To properly select a diet, you should seek help from a dietitian or, alternatively, completely eliminate prohibited dishes.
Examinations of the doctor
Provided that you do not have any complaints, the first examination by a doctor should be done in a month. The medical specialist prescribes a blood test, a coagulogram and an ECG, which are basic examinations. In the future, the doctor should visit 3 months and then 1 every six months. Such visits are mandatory and allow better control of the pacemaker as well as your heart muscle.