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All about Pacemaker procedure single chamber

  • Posted on- Jan 06, 2018
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Single chamber pacemaker can be described as pacing systems which only uses single lead in the right atrium or right ventricle inside the heart.

A single lead in the right atrium is commonly used in conditions where the normal pacemaker of the heart is not working adequately, such as in the case of sick sinus syndrome. Atrial pacing is used when the sinus node is sending out signals that are too slow or irregular. For use of pacing method, the heart normal conduction system is carried out normally.

More commonly, the single lead is placed in the right ventricle to help correct a slow or irregular heartbeat. It happens in the most common case that is slowed down from its regular speed or gets the blockage in the origin of the atrio-vascular node and the simple pulses get restricted from reaching the ventricle. This would result in too slow a heartbeat.

The pacemaker system would keep the heart beating at a steady rate.

The pacemaker is defined as the electrical device, sending electrical signals to the heart for help it to beat properly at real rate. The pacemaker is surgically placed under your skin, beneath your collarbone, and is connected to your heart by one or more wires, or leads. A single chamber pacemaker has one lead placed within the lower chamber or ventricle of the heart.

Pacemakers are used to treat bradycardia and atrial fibrillation associated with bradycardia. Bradycardia is an abnormally slow heartbeat defined by 60 or fewer beats per minute. Bradycardia results at a time when electric signals are not produced at a fast enough pace by the SA (sinoatrial) node, or when these signals do not reach the ventricles. Atrial fibrillation is an irregular heartbeat in which abnormal electrical signals originate in the upper chambers of the heart or atria. Atrial fibrillation causes the rhythm of the heart rate to slow down, which results in bradycardia.


Why is pacemaker done?



The pacemaker is implanted to help in the control of your heartbeat. It can be implanted temporarily to treat a slow heartbeat after a heart attack, surgery or overdose of medication. In case, pacemakers can be implanted permanently to cure the slow heartbeat rate or more severely for the treatment of heart failure.

Smaller pacemakers about the size of a pill have been developed and are currently undergoing clinical trials. It is a new leadless device, which is implanted into the heart, in which its work is for emitting impulse for the controlling of the heartbeat. Because a lead isn't required, this device can minimize the risk of infection and speed recovery time.

When the electrical signal gets abrupt in the origin of AV (atrioventricular) node is called heart block. The AV node is the only electrical connection between the upper chambers (atria) and the lower chambers (ventricles). The main reason behind the occurrence of Heart block is the delay of heart signal or isn’t passing through in the AV node for lowering pump chambers.

Heart block can also be the result of an aging cardiac conduction system or can be related to certain medications or cardiac surgical procedures. There are varying digress of heart block that can occur. The ventricles, unless stimulated by a normal signal, can only generate a heart rate of 20-40 beats per minute on their own.

In this situation, the heart rate is much too slow to meet the normal demands of the body. Most individuals who develop significant heart block feel poorly and may pass out. The pacemaker will maintain the heart rate within the normal range according to your specific needs.

What is a pacemaker single chamber system?



The pulse generator can be defined as a tiny implantable device whose size is similar to four stacked half dollar coins. Inside its metal shell, the pulse generator contains the electronic circuitry (capacitors or transistors), which continuously analyzes the heart's rhythm and regulates the pacemaker function, as well as a lithium battery that provides the power source for the device.

What is the recuperative time for pacemaker single chambers surgery?



Recovering from pacemaker surgery is rather quick. You may either go home the same day, or most patients spend one night in the hospital following the procedure. There may be some minor discomfort following the procedure. Tylenol or other over the counter pain relief medications can be used as needed. Most individuals feel fine within a few days. Stronger pain medication can be prescribed as needed based on your level of discomfort.

As with any surgical incision, you should avoid getting the pacemaker site wet for at least 48 hours. In case, after noticing any swelling, tenderness or warmth at the pacemaker, then it becomes mandatory for you to call your physician, to protect the case from getting worse.

What is the complication of pacemaker single chamber?



Failure to output: One reason could be battery failure, lead fracture, a break in lead insulation, over-sensing (inhibiting pacer output), poor lead connection at the take off from the pacer, and 'cross-talk' (i.e. a phenomenon is seen when atrial output is sensed by a ventricular lead in a dual-chamber pacer).

Failure to capture: This may be due to lead fracture, lead dislodgement, a break in lead insulation, an elevated pacing threshold, myocardial infarction at the lead tip, certain drugs (e.g., flecainide), metabolic abnormalities (e.g., hyperkalaemia, acidosis, alkalosis), cardiac perforation, poor lead connection at the take off from the generator, and improper amplitude or pulse width settings.

Over sensing: Pacer incorrectly senses electrical activity and is inhibited from correctly pacing. This may be due to muscular activity, particularly over-sensing of the diaphragm or pectorals muscles, electromagnetic interference, or lead insulation breakage.

Under sensing: This may be due to poor lead positioning, lead dislodgment, magnet application, low battery states, or myocardial infarction.

Pacemaker surgery single chamber costs minimum for Rs. 60,000 to maximum Rs. 1,20,000.

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