Implantation of the pacemaker - Causes, symptoms and treatment. MF.
The only method of treatment of a rare heart rhythm( bradycardia) is the implantation of an electrocardiostimulator. This device restores the normal heart rate. At the same time, the volume of blood coming to the organs is normalized, and the symptoms of bradycardia are eliminated.
What are the most common conditions requiring the use of a pacemaker?
The main indications for permanent cardiac pacemaker implantation are:
Atrioventricular blockade with clinical manifestations of bradycardia( dyspnea, dizziness, fainting) or pauses for more than 3 seconds.
Syndrome of weakness of sinus node with clinical manifestations of bradycardia or heart rate & lt;40 beats per minute in waking state.
Note. If the bradycardia has no clinical manifestations, then the need for surgery is usually absent.
What is a pacemaker?
The permanent pacemaker is a complex electronic device consisting of a power supply, a microprocessor and a system for generating electrical impulses. All this "stuffing" is packed in a miniature titanium case, indifferent to the tissues of the human body. This device is connected to electrodes( special "conductors"), which are guided through the veins directly into the heart cavity( in the atrium or ventricle) and serve as the "eyes" and "hands" of the pacemaker. By electrodes, the cardiac pacemaker receives information about the work of the heart, and pulses are transmitted from the apparatus to the cardiac muscle. Thanks to such a system, an electrocardiostimulator, that is, a "brain center", there is no need to be directly in the heart. It is usually located in the area of the large pectoral muscle( usually on the left, to "save" the working hand).
Currently, all pacemakers are "on demand".Thanks to the electrodes, they feel the natural rhythm of the heart and emit pulses only when the spontaneous rhythm of the heart falls below the established( basic) heart rate. The most important information is stored in the memory of modern pacemakers - the number and type of rhythm disturbances, stimulation efficiency, the state of the power source, etc.
The adjustment of stimulation parameters after implantation of the pacemaker is performed by the doctor using a programmer, a computer device that reads data stored in the pacemaker memory and sets the stimulation parameters. For reprogramming the device, of course, there is no need for surgical intervention.
What are the types of pacemakers?
Pacemakers can provide stimulation of one or two chambers of the heart( we will talk about the three-chamber stimulation separately in the section "Treatment of Chronic Heart Failure").A single-chamber stimulant can "sense" and stimulate only the ventricle or only the atrium. The two-chamber pacemaker "feels" and sequentially stimulates both chambers of the heart. In addition, many devices have a function of frequency adaptation( or sensor), which allows you to assess the level of physical activity performed by a person, and speed up the heart rate, according to the natural needs of your body.
The most famous manufacturers of pacemakers are Medtronic, St Jude Medical, Guidant( USA) and Biotronic( Germany).In Russia, pacemakers are produced by Cardioelectronics( Moscow), Elista-Cardio( Moscow) and Izhevsk Mechanical Plant.
What are the resources of pacemakers?
Pacemakers are reliable and safe devices. This allows manufacturers to give a long-term guarantee for their work( usually 4-5 years).At the same time, the real life of the devices is about 8-10 years. The duration of the pacemaker depends not only on the state of the power source( more often, the lithium-iodine battery), but also the set amplitude of the stimulation, the number of additional options connected( for example, frequency adaptation), electrode states and other causes. When the system is checked every year, the doctor evaluates the condition of the power supply of the pacemaker. For a number of parameters, he can determine the signs of battery exhaustion before the stimulator changes the frequency of stimulation. Usually, the pacemaker is designed for several months of work, even after reducing the frequency of stimulation. This allows the doctor to schedule a scheduled replacement of the pacemaker. Since the "battery" is built into the body of the pacemaker, it must be replaced in its entirety. About that, you need to replace the electrodes, sometimes you can say before the operation. But most often this issue is finally resolved in the course of surgical intervention. If the condition of the electrodes is satisfactory, they will be connected to a new pacemaker