ok. my heart isn't working properly and I need a pacemaker? Does anyone know how the surgery will work?

Question

I'm asking cause the doctors just told me I needed surgery! How nice

Answer 1

Sometimes once we know a patient needs a pacemaker we will briefly discuss the matter and refer the patient to an electrophysiologist (EP). He/she is a specialized cardiologist who deal strictly with the electricity that causes your heart to beat.

The procedure of actually having a pacemaker implanted actually goes rather quickly in experienced hands (less than one hour). I absolutely would not allow a device to be implanted unless it is with a physician who specializes in these procedures (not a general surgeon).

A small incision (3-4 inches) is made below you collar bone of your non-dominate hand. A pocket to accomodate the device about the size of a credit card and as thick as two silver dollars is made between the skin and above the muscle. A small incision is made in your subclavian artery and the leads are advanced down and into your heart. Usually one lead is on the top of the heart (atria) and the one lead is sent to the bottom of the heart (ventricle). The leads have a small corkscrew-like end and it is twisted into the side of the heart to anchor it. The leads are connected to the device and it is tested to be sure it is working as it is supposed to. The device is then sealed (often with glue to avoid sutures and infection) inside the pocket. You will be restricted in raising your arm affected arm above your shoulder for about 4 weeks after the procedure.

Patients in our practice stay over night in the hospital after a new device is implanted on telemetry (monitoring of your heart) to ensure the device is functioning as it should. The are discharged the next morning. We have them back in the office at one week for a wound check and to verify the device continues to work as it should.

The surgeon or one of his/her assistants will tell you more specific details if you are inclined to want to know more.

Good luck.

Answer 2

Hi Nia.. I am an x-ray tech. I do the fluoro(x-ray) during pacemaker cases all the time .:) You will be given a medicine to make you slightly sleepy, but you won't go to sleep. The Surgeon will numb an area near your shoulder/neck, and insert a catheter. He will then place a guidewire through there into your subclavian artery to your heart. The pacemaker leads go over the wire into place. (this is as accurate as I can tell you from my standpoint, but you get the idea, right?) :) When the wires are in place, he will set your rate with a temporary pacemaker. When he gets the rate he wants he will numb the area where he will put your permanent pacer, make a pocket in the skin, connect everything and sew it up. You shouldn't have too bad of a scar, and all of the patients I see say it is a piece of cake. Oh yeah, then here comes me, the x-ray tech with the cold hands and cold hard plate to take a portable chest x-ray after wards to make sure everything is in place, and you don't have a pneumothorax ( a part of a collapsed lung). You should be just fine, I am hoping all goes well for you, try not to be afraid:):):):) p.s. ask the x-ray tech for a lead apron to go over your ovaries. Even if you can't have kids or something, you should still protect your ovaries, some pacemaker cases take a lot of fluoro time depending on the doc. good luck:)

Answer 3

I've been in the position of being through the surgery. I can tell you what you will probably see.

I got to the hospital, was assigned a room. They might play one of those stupid living with a pacemaker videos for you. A tech came to run a few tests on my heart, i.e. attach some pads to me for a couple minutes. A nurse did the standard blood pressure, weight, etc at some point.

About a half hour to an hour before surgery a nurse shaved and scrubbed my left and right shoulders. At which time they explained to me that the device will be put well I am right handed, they were planning on my left shoulder. However if they have any problems they will go to the other side. They stayed on my left side. I believe I was hooked up to an IV at this time too.

About 10 or 15 minutes before they come to retrieve you they give you a pill that does most of the sedation.

Then they came to transport me down. The nurse helped me walk from one bed to the one they were talking me to surgery on. I needed the help to steady me. We got to the surgery room.

They strapped down my arms and legs, covered me with some sort of sheet and slide off my hospital robe. They did more shaving and attached a lot of pads for monitoring to me. The doctor asked me a few questions. I wasn't that coherent at that point, so I imagine I sounded very drugged. They gave me a shot of something else as I'm sensitive to iodine and they don't want to risk an allergic reaction. Then inject a solution into me for a xray. The solution contains iodine. The x-ray they took was on a monitor in front of me. It was kind of interesting to see. What it showed is a major blood vessel going to the heart and the surrounding bones.

Then they asked me to turn my head to the right. They covered my head with a sheet only to build a tent around my head a bit later. I could only see one color from here on. Most people fall asleep at some point following this. With the injection to prevent the allergic reaction, it was guaranteed with me. The next thing I remember is feeling a jolt in some sort of dream like world. The doctor latter told me there was more than one.

A while later I was in bed in my room. My head and left arm had plenty of pillows and arm was in a sling. I don't remember much more about the day. I know the nurses have me some very strong pain medication every handful of hours. They were upset that I didn't request more medication. They helped me order supper. The food was moderately good. Just slightly better than fast food quality. Otherwise it was TV and sleep.

The next day you get to talk with the surgeon, technicians come and set a device on top of your pacemaker that is connected to a computer. They do something and leave. Maybe your original doctor will stop in if he has time.

I wasn't allowed to lift my arm above my shoulder for 7 weeks. It was suppose to be 8 weeks originally but the doctor didn't hold to that. 10 to 14 days after I visited the pacemaker clinic. They programmed the pacemaker and introduce me to another device they ordered for me that would read my pacemaker from home and send a fax. After another month they sedated me again and purposely induced heart problems to see how my pacemaker reacted.

That is where i am now. This happened just a handful of months ago. A pacemaker or defibrillator are insurance to make certain that your heart doesn't do something to kill you in the future. I should have one because I have the same heart disease as my old sister died from.

Answer 4

I am a registered nurse in a whole different field, but I do know you have the right to what is called informed consent. Your cardiologist is obliged by the law to explain the procedure to you and give you time to ask questions and get answers to the questions. You also must be informed of the benefits and the risks of the procedure which almost always include things such as infection, hole in the heart, death etc.
If your doctor is not taking the time to explain these things to you, I would be inclined to think he is a money grubbing jerk who doesnt care about his/her pts concerns I would find a new doctor. I dont mean to sound like a rip, but I find foreign doctors often suffer from over inflated self and treat their American patients like crap. I work with them and I know this to be a fact.
Dont waste any time. If you need a pacemaker, it should be done ASAP.
Please get a 2nd opinion. Insurance companies pay for 2nd opinions on a routine basis and you most certainly deserve one.
I am a heart patient myself and found out I did not need a pacemaker about a year ago and I am concerned for you.
Also, a cardiac electrophysiologist is the kind of MD you need to be talking to.

Answer 5

they attach normally two electrodes to the two side's of your heart, they also roughly at the same time take a tracing of your hearts electrical patterns they then match the pacemaker to this and then test it by stopping your heart whilst your on the table to see if the pacemaker has captured the natural rhythm of your heart and waits for it to 'fire' sending a measured charge into your heart so a normal pattern returns, when this is achieved and it really doesnt go wrong that often, they then find a 'pocket' to put it in the chest,it will sit just under the skin in between the skin and muscle. your doctor should of told you this.

Answer 6

Well this bloke first puts you under then he chops open your chest and squashes in a bit of machinery. This thingy gives your heart an electrical thump if it goes on strike and keeps you ticking over... Don't ride on the big dipper after the op, and try not to get over excited or over enthusiastic with your love life. Never let a well endowed female climb on top of you, the sheer weight could do you in! Otherwise you should make it to ninety. Sorry I can't explain things better, but I only assist in the operating theatre, They don't let me have a go at the actual operation... don't know why!!!!!

Answer 7

Hope you get the answers you are looking for, I was born with eight defects to my heart and I'm getting to the point where I am going to need a heart and lung transplant soon. I'm 34, but to this day, not one doctor has even attempted to tell me what is wrong with me in a way I can understand.
Good luck, I hope everything goes well for you!

Answer 8

I have SVT and have to have Catheter Ablation therapy next year. I looked up what happens during the procedure on the internet, and believe me, too much info just causes your heart to go even faster!! Your Healthcare professional should be able to give you all the facts you want to know, and probably some more that you wish you hadn't asked! Good luck x

Answer 9

Leads are place thur a vein into the heart attached to the atrail wall anthor lead is placed on the ventricular wall then a pace maker is put into a pocket that is under the skin. This will keep the heart in rhythm is needs be the pace maker will shock it back into rhythm

Answer 10

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