When are Pacemakers Used? - Pacemakers may be Prescribed for a Number of Conditions

Artificial pacemakers are devices that are implanted into the body, just below the collarbone, to take over the job of the heart’s own electrical system and prevent slow heart rates. Although they weigh only an ounce and are the size of a large wristwatch face, a pacemaker contains a computer with memory and electrical circuits, a powerful battery (generator), and special wires called “leads.” The generator creates electrical impulses that are carried by the leads to the heart muscle, signaling it to pump.

Getting a pacemaker does not require open-heart surgery — the procedure usually takes only about two hours. The pacemaker generator is implanted in a small pocket made under the skin. The leads are usually placed in a vein near the collarbone, and then moved to the heart with the help of an X-ray machine. The leads touch the heart muscle on one end, and are connected to the pacemaker generator on the other end. The pacemaker is programmed to send signals to the heart, and settings can be changed at any time. Routine monitoring, some­times even by phone, makes sure the pacemaker is working properly. The battery in the generator lasts 5-10 years and must be replaced when it runs out.

Type of Pacemakers

• Single Chamber Pacemakershave one wire that is placed in the right upper chamber (atrium) or lower chamber (ventricle).
• Dual Chamber Pacemakershave two wires, one in the atrium and one in the ventricle.
• Biventricular Pacemakers have three wires, one in the right atrium, one in the right ventricle and a third in the left ventricle. These more complicated pacemakers take more time to implant, and can be used to improve pumping in patients with heart failure.
• Rate Responsive Pacemakers adjust the heart rate to a patient’s level of activity. They pace faster when a patient is exercising and slower when a patient is resting.

When are Pacemakers Used?

Pacemakers may be prescribed for a number of conditions, including:

• Bradycardia
  A condition in which the heart beats too slowly, causing symptoms such as fatigue, dizziness or Fainting spells.

• Atrial fibrillation (AFib)
  A common heart rhythm disorder in which the heart beats too fast and chaotically. Sometimes, people with AFib can also have slow rhythms. Medications used to control atrial fibrillation may result in slow rhythms, which are treated by pacemakers.

• Heart failure
  A condition in which the heartbeat is not strong enough to carry a normal amount of blood and oxygen to the brain and other parts of the body. A special pacemaker can be programmed to increase the force of heart muscle contractions. This is called “biventricular pacing” or “resynchronization” therapy.

• Syncope
  A condition best known as “fainting,” usually not serious. Some patients faint when their heart rate becomes too slow. A pacemaker prevents slow heart rates and can cure syncope in some patients.
  
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Low treatment costs and high levels of expertise have made India a leading destination for heart treatment

Low treatment costs and high levels of expertise have made India a leading destination for heart treatment for people from West Asian and African countries, doctors said.

According to doctors, the rates of heart treatment are 1/10th to 1/15th times lower as compared to the United States and Britain.

India has now become a hub for heart treatment in Southeast Asia and people have been flying in from foreign countries and undergoing treatment for various cardiovascular diseases here . People visiting India for treatment are not only from neighbouring countries like Pakistan, Afghanistan, Bangladesh and Nepal but also from far off countries like Nigeria, Kenya, Uganda, Kazakhstan, Iran, Iraq, Yemen and Oman.

Compared to global standards, the rates for any kind of cardiovascular surgery are very minuscule in our country . Coronary angiography (a test that uses dye and special X-rays to show the insides of coronary arteries, the tube that carries blood to heart) costs around Rs.10,000 to Rs. 15,000 in India and around 500 dollars (Rs. 32,000) in the US.

The most popular treatments availed of by people who come to India are angioplasty, where the blockage in the coronary artery is opened and a thin coil, called a stent, is implanted; open heart surgery where the heart holes are closed and narrow valves opened; and the installation of artificial pacemakers for slower heart rates.

Low treatment costs are definitely one of the major factors attracting people to India, but the expertise and trust in the quality of treatment is another reason for the growth of foreign patients.

"All the latest high quality treatment is available in our country and with high expertise we have been able to establish trust among foreign patients.Similarly, even for treatment of congenital heart disease (diseases affecting infants and children and present since birth) several hospitals are attracting a lot of patients from abroad.

The treatment is even cheaper in government hospitals, with the difference being usually between Rs.75,000 and Rs. 1 lakh.

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