Permanent Pacemaker Implant Cost in India

A pacemaker is an electronic device implanted in the chest or abdomen to control the heartbeat at a normal pace using electrical pulses. Permanent pacemakers are made in such a way that it responds to the condition of the heart. The lowest heart rate is set in the pacemaker and if your heart rate drops below the set rate, it fires electrical pulses to stimulate faster heartbeats so that it could beat at a normal rate.

Pacemakers are of two types. Temporary pacemakers are used to treat short-term heart problems that slow down the heartbeat-like heart surgery, heart attack, or overdose of medicine. Permanent pacemakers are used to control problems of long term heart rhythm.

A pacemaker contains:

• A computerized pulse generator to enable electrical signals to regulate the heartbeat
• One to three leads, wires that deliver signals between the pulse generator and your heart
• Electrodes to help deliver signals
• A battery

The pacemaker is small and about the size of a matchbox weighing 20 – 50 grams. It recognizes your body movement or your breathing rate.

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Indications for a Permanent pacemaker 

Patients have advised to implant a pacemaker if they suffer some condition such as:

• Bradycardia (heartbeat slower than normal)
• Tachycardia (heartbeat faster than normal)
• Heart block due to aging, heart damage
• Sick sinus syndrome
• Atrial fibrillation
• Need to take heart medicines such as beta-blockers
• Fainting or other symptoms of slow heartbeat
• Heart muscle problems
• Long QT syndromes
• Congenital heart disease
• Heart transplants

Types of Permanent pacemakers

 The type of pacemaker you need depends on your condition and specific heart problem you have. There are three types, namely,

• Single chamber – it has one lead that connects the pulse generator to one chamber of the heart. This is to stimulate pacing in one chamber.
• Dual chamber – it has two leads connecting to both chambers on the right side of your heart, the right atrium, and right ventricle. This helps regulate the rate of contractions in both sides of the chamber.
• Biventricular chamber – it has three leads connecting to the right atrium and two ventricles. It is used to treat people with arrythmias caused by advanced heart failure.

Diagnosis and tests

• Physical examination
• Blood tests
• Electrocardiogram
• Echocardiography
• Holter and Event monitors
• Electrophysiology study
• Stress test

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Procedure

 Before surgery:

• Your doctor will take a physical examination of your body
• Diagnostic tests must be performed
• You may inform your medical history with your doctor along with your allergies and current medicines taken
• You will be asked to stop certain medications such as blood thinners
• If you have diabetes, ask how to adjust your insulin or diabetes medications
• You will be asked to stop eating and drinking 8 – 12 hours before surgery
• Medications should be taken with small sips of water only
• The area of implantation may be shaved or cleaned to reduce any chance of infection
• An IV line will be inserted in your vein to receive medications and antibiotics

During surgery:

• You will be given local anaesthesia, so the area of implantation will be numb, you will be drowsy but feel no pain
• The procedure lasts between 2 – 5 hours
• An ECG and blood pressure monitor will be used to record your heart rate and blood pressure
• Your doctor will insert a large needle into your vein to transport the wires into your vein and place them in your heart
• A small incision, about 5 – 10 cm will be made below your collar bone for the pacemaker, another incision will be made under the skin for the pacemaker battery
• A lead will be inserted into a nearby vein to be passed to the heart
• The lead is tested and is connected to the pacemaker
• The incision will be closed, and dressing made to the wound.

After surgery:

• You will stay at least for a night in the hospital
• The doctor uses an external device to set the pacemaker settings
• The pacemaker is checked to see it working normally
• Your heart rhythm will be continuously monitored
• A chest X-Ray will be done to check your lungs and the positions of the pacemaker and lead
• You may feel soreness, swelling or pain in the area where the pacemaker is placed. Pain medication can give relief
• You will be instructed on how to care for the pacemaker
• It is recommended to limit arm movement especially on the side of the pacemaker to give time to the pacemaker electrodes to attach themselves inside the heart
• You will receive a temporary pacemaker identification card so that you could show it in the airport
• Regular check-up is needed to ensure the pacemaker is working properly.

Helpful: Types of Pacemakers

Risks and complications

As with any surgery, it comes not just with benefits but also risks albeit low. Possible complications are:

• Blood clots
• Pacemaker infection
• Pneumothorax
• Pacemaker malfunction
• Twiddler’s syndrome
• Bleeding/bruising

Factors affecting the cost of Permanent pacemaker implant single chamber

The cost of this surgery is about $3200. Cost price vary depending on factors such as:

• Choice of hospital
• Location of hospital
• Surgeon’s fee
• Medical care
• Duration of hospital stay
• Diagnostic tests