A pacemaker is installed by surgically inserting one or more wires into a major vein near the collarbone and guiding them to the heart using X-ray imaging.
Here's a more detailed breakdown of the pacemaker installation procedure:
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Preparation: The patient is typically given a local anesthetic to numb the area near the collarbone. Sometimes, a sedative is administered to help the patient relax. The insertion site is then cleaned and sterilized.
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Vein Access: The doctor makes a small incision, usually near the collarbone, to access a major vein.
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Lead Placement: One or more insulated wires, called leads, are inserted into the vein. The doctor uses fluoroscopy (real-time X-ray imaging) to guide the leads through the vein and into the correct chamber(s) of the heart.
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Lead Anchoring: Once the leads are in the proper position, their tips are anchored to the heart tissue. This ensures they stay in place and can effectively deliver electrical impulses.
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Generator Placement: A small pocket is created under the skin, usually near the collarbone, to hold the pacemaker generator (the part that contains the battery and circuitry).
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Connection and Testing: The leads are connected to the generator. The doctor then tests the pacemaker to ensure it's functioning correctly and pacing the heart as needed.
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Closure: The pocket is closed with sutures, and the incision is covered with a sterile bandage.
Key Aspects Summarized:
- Anesthesia: Local anesthetic is usually used, sometimes with sedation.
- Incision: A small incision is made near the collarbone.
- Vein Access: A major vein near the collarbone is accessed.
- Lead Insertion: Leads are guided to the heart chambers using X-ray imaging.
- Generator Placement: The generator is placed in a pocket under the skin.
- Testing: The pacemaker's functionality is verified.
- Closure: The incision is closed.
The entire procedure typically takes a few hours, and most patients can go home the same day or the next day.
