Hello to all of you, and a very good afternoon. At the very outset, before we start this small session on, how do I look after my pacemaker, I wish to share with you that COVID times are here, we must take utmost care, we must continue to behave in COVID sensitive mannerisms. We have had sessions in the past where we’ve spoken about mask-wearing social distancing and high hand hygiene.
We’re right there where we were about a year ago. So please remember that we must remain and continue to have COVID-sensitive behavior. Coming to the subject that we wish to speak on today is how do I take care of a pacemaker? So let me say, why do we choose it, we chose the subject because there seems to be an inherent fear among people, that if they were to have any kind of device in their body, it may hamper their daily living, to be a very simple thing to say that whenever we as medical personnel intervene, it is only to make the life of fellow mankind better.
So when we give any devices, we eat in the heart, beating your knees, beating your shoulder, all of these, these are meant to make your life better. So if you want to speak about pacemakers, and you want to talk about this, because the whole thing to understand is who needs a pacemaker is to be understood first.
Who Needs A Pacemaker?
I will just try and make you understand that this is the structure of the heart, we have two upper chambers, and we have two lower chambers. For all of us, the electrical impulse comes from the upper chamber, it first goes to the upper chamber, then it goes down with the help of special electrical wires. This is just like you have electrical wires in your home. Similarly, we have electrical wires in our hearts. More often than not, just so the new homes, the electrical wiring can break, you call the electrician, the electrical wires may switch off for some time, similar in the heart, these electrical wires can become dysfunctional, as we age.
Sometimes, the natural pacemaker of the heart begins to march slowly. And other times the other part of the electrical system may become dysfunctional. So how does the patient present it, the patient presents themselves with weakness, fatigue, or we have very traumatic symptoms, such as having a fall and fainting. So whenever your family if an elderly patient or a middle-aged and about complains of a fainting spell, it needs to be given its due importance, you must seek medical attention, you must do an ECG. Right now we have several diagnostics, which we can do an ECG picks up the rhythm right then sometimes the ECG may not pick it up, then we tell our patients to do a full job.
This is how the folder looks. Look, it is so simple. It just has three electrodes, which are stuck to the surface of the chest. And this is a pocket we give to this device in this pocket. It records ECG for 24 hours, 48 hours, maybe one week, maybe two weeks.
That is the utility of an extended loop recorder. Or sometimes we may use an ECG machine as compact as this loop bonuses. This is like a visiting card. But technically, it is so advanced. What does this do? This records an ECG. How does it do that? It is very simple. All we got to do is have an application on our phone. And before this device in our fingers, our comes just by simply holding this little device, which is just like a car you’re visiting car. You can record your ECG in the comfort of your home, capture the episodes of dizziness, and immediately sent it to your so I think we had a little technical glitch. So taking off. This is how a cardiac implantable device looks.
It could be a pacemaker It could be a defibrillator, it could be a biometrical, a pacemaker with a defibrillator. And typically these devices look like this. These are bigger than their defibrillators, the pacemakers are much, much smaller, but that’s how they look, the pacemaker and these are the leads, the leads go inside and the pacemaker is inserted. So, that is to tell you about who needs a pacemaker, you have just understood that.
How is the Pacemaker Implanted
I just told you, the pacemaker has put the place under the left collarbone, and the lead goes inside the heart. And that is how a pacemaker is implanted. Not obtained after we get the pacemaker, how is it that you have to look after the pacemaker it’s not just a pacemaker. They’re called cardiac devices. They could be a pacemaker. It could be a defibrillator.
It could be a cardiac resynchronization therapy defibrillator it could be any of these devices, how is it that you need to look after them. So you should not be worried these devices are only to make your life better. So to say, once this pacemaker is implanted, during the acute phase, because this is placed under like this pocket, we make a pocket and Mr. Chuck the skinnier you cannot see anything from outside. But because it is a rock walking, we have just made one, you have to ensure that you take a course of antibiotics, because antibiotics typically last for about five to seven days, you must try not to miss your antibiotics.
Some of us may be allergic to antibiotics or may have some problems like not sure motions, you need to go back to a doctor and your doctor will change the antibiotic. The reason we give antibiotics after the implant is we have to be very careful. Whenever we give implants. We don’t want any infections to take place. Those patients who are diabetics must ensure that their blood sugars have been under control. Because we don’t want high blood sugar during the procedure, which can at times give rise to infections after the procedure.
So the first thing is to remember that you have to take antibiotics, and the antibiotics must continue for at least five to seven days.
The next thing you have to remember is when you go home off the pacemaker, you must remember that you can lift your arms up to this level, the shoulder level; we always instruct our patients to remember to keep their shoulder moved by a subset of patients are very scared, and they have pain to not raise their shoulder. By doing so, if you don’t raise your shoulder, it can result in a frozen shoulder.
So what we tell our patients, the first five to seven days, raise your shoulder, raise your arms up to shoulder level. Subsequently, you can take your arms above your shoulder. And these are all instructions with a pacemaker is implanted. We also instruct our patients that they should not be for about five to seven days after the pacemaker is implanted. Because it is a wrong move.
It is healing. We don’t want any infection in the pocket. You must remember sometimes the pacemakers are given in the summer season, we must ensure the patient is not in a hot and humid climate. We don’t want the patient sweating and the patient’s sweat falling in his own room.
By doing so, again, if it is all soiled, it can get infected. So up till now, I have been repeatedly saying in talking about how we need to keep our pacemaker site clean, dry, and should not get infected. We keep calling our patients every 48 hours for repeat dressing. We do these dressings at least three to four times. And we like that our patient goes back to the same doctor who was implanted because by doing so, we are all in close contact and we are able to assess the healing of our patients, and most patients, the local site heals in five to nine days.
However, there could be some outliers, wherein the route can take a bit longer. It is important to understand that we should not become impatient. We should continue to Seek an Appointment With The Best Heart Specialist Doctor and keep going back so that you’re implanting doctors’ confidence and tells you that you don’t need to come back again. Till then keep going back to your doctor.
The pacemaker site normally has absorbable sutures. However, when you have any injury route, what you should remember is when you have a Spaceman on the left, you should avoid sleeping on the left. If you have a pacemaker on the right, avoid sleeping on the right for at least one week to 10 days, because we do not want any blood collection on the pacemaker site.
Along with this, I want to tell you, those of you who are on blood thinners, and need some procedures, like a pacemaker, it’s important to discuss with your doctor that you are on blood thinners, we may want to either stop the blood thinner for a day or two, or we want to do the procedure on the blood thinner depending upon your clinical condition.
At this time, when we’re talking about this, I think it’s important we also discuss at the very end about the vaccine and practitioners because many of you who want to learn about what to do not to know when you have to get vaccinated, which I will certainly touch about. If you want to develop a fever at any point in time, after the pacemaker the first one week or 10 days, you must immediately go back to your doctor.
But the most important thing is the cell phone whenever you go in closing except for you should try to keep the cell phone on the contralateral here means if you have a pacemaker on the left, use your mobile phone from the right if you have a pacemaker have the right key the mobile phone on the left this you have to follow for a lifetime.
The reason being there are certain magnets that are good with the pacemaker, these magnets will interfere with your pacemaker. So much so that we should all know the newest generation of iPhone, which is the iPhone 12.
Those of you who are using these into the scanner, to those of patients who have who are having an iPhone 12 and have cardiac devices, especially like defibrillators must remember to keep their iPhone specifically aware and should not place the iPhone in their upper pocket. You should always keep your cell phone in the pockets of your trousers or in your handbag. Do not place your smartphone in the chest pockets. Even more.
So if you are having an iPhone 12 because you must be aware that the charging strategy of iPhone 12 has been altered, they have gone bad, and so forth on the battery charges. As a result, would they have done that the iPhone has a very strong magnetic field inside the iPhone 12? If you will place it in your pocket, there will be some issues.
So remember always to use your iPhone from the contract like to hear. The next thing which comes up is the electrical appliances at home, which applies to the time all the time where pacemaker orthotic device implanted. So what happens when you have a microwave or you have your mixie you won’t be able to make so you want to use a television remote, you want to use a remote phone.
So you should remember that all the electrical appliances at school can be used when you have a pacemaker. A word of caution is that when you are traveling or you’re you are working or you are staying where the very strong electrical transformers, the ones that you see which are placed in colonies to supply the electricity, you should not be pouring around those electrical Transformers because they have magnetic fields and they can interact with a pacemaker.
When you’re in airports, whenever you have a pacemaker or cardiac device and you are at the airport, what you should remember is whether there is a personnel who do they just walk through them the handheld device for the surveillance, they do not bring it if you show them the God, you must always carry your guardian device card in your wallet. Once you show them the card does not bring that handheld device on the pacemaker pocket.
So you should remember that it’s a very safe environment today. And we have in fact now we have pacemaker-safe electrical appliances where if a doctor asked for an MRI today, most of the devices that we have are excellent right complexity. Most devices allow you to have an MRI done. So when you get the implant they’re done. You should talk to a doctor who should want an MRI-compatible device. What does it mean? MRI compatible device as the name implies means that if you have a device, you can have the MRI done of your body, if you need time to come, if you have an MRI noncompatible, it is challenging, and it is not yet completely advisable that you can have an MRI done.
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So other than that, I think I would like you to know that you should know the make the industry make of the device you should always carry because of your pacemaker or the Guardian device, you should be knowing whether this MRI compatible or not, you should be in constant touch with your doctor, your device has to be interrogated or checked every three to six months, there are several ways it can be done, you will want to visit us attend the pacemaker clinic. Or you can also have a device checked remotely yet.
Outside of this, you should remember the battery-operated devices, the battery is embedded in this unit. When we change the battery, the battery finishes, we remove this device, and we want a new device, we do not just remove the battery, we remove this device and we give you a new device. These are battery-operated devices. The typical life these devices were with anywhere between seven to 14 years, depending upon what device we are using. So I think I would like to conclude here, and I will be happy to take some questions.