Pacemaker Surgery Cost in India

What is Pacemaker Surgery Cost in India?

Pacemaker surgery stands as one of the most common procedures to treat irregular heart beats. In India, over 20,000 pacemakers are implanted every year, and this number continues to rise annually, reflecting an increase in the rate of heart diseases. This could be due to shifting lifestyles, poor dietary choices, increased stress, lack of exercise, and inadequate healthcare infrastructure in certain regions.

The average cost of pacemaker surgery in India ranges between INR 2,50,000 and INR 4,50,000 for Indian patients. For International patients, the cost ranges from USD 6000 to USD 7500. This cost includes the pacemaker price, surgeon fees, anaesthesia charges, OT charges, medical consumables, and a hospital stay for 2-3 days.

What is Pacemaker Surgery?

A healthy heart is essential for overall well-being, as it pumps blood to all parts of the body. A typical resting heart of an adult beats 60 to 100 times per minute. The range may vary with age, sometimes during vigorous activity or the emotional state of a person.

Once the condition responsible for the temporary imbalance has been resolved, the heart rate returns to normal. But if the condition persists for longer than usual, it should not be neglected. 

Dysregulations, such as bradycardia (slow heartbeat), tachycardia (fast heartbeat), arrhythmia (irregular heartbeat), or heart failure, cause symptoms such as extreme fatigue, dizziness, syncope, and shortness of breath. If not treated on time, these can be fatal, too. 

So, in order to treat such heart complications, pacemaker surgery is done. In India, 0.2% of cardiac patients undergo pacemaker surgery annually. It involves the surgical implantation of a battery-operated medical device, a pacemaker in the heart. This device sends signals to different chambers of the heart in cases where the sinoatrial node or SA node (the natural pacemaker of the human heart), atrioventricular node, and HIS-Purkinje system are not working properly.

It mainly consists of two parts-

• Pulse generator: It contains the pacemaker’s battery and other electronics. It generates and controls electrical signals sent to the heart muscles.
• Leads: These are thin wires that help distribute the electrical signals from the pulse generator to the heart. Some of the latest pacemaker devices don’t have these leads and are referred to as leadless pacemakers.

The most common heart conditions treated by pacemakers are as follows-

• Arrhythmia: It is characterised by irregular heartbeat.
• Tachycardia: In this medical condition, the heart beats more than 100 beats per minute. If the racing heartbeat is irregular as well, it is called tachyarrhythmia.
• Bradycardia: In this medical condition, the heart beats less than 60 times per minute. If the slow heartbeat is not persistent and irregular, it is called bradyarrhythmia.
• Congestive heart failure: This condition arises when the heart is not efficient in pumping blood to the body, resulting in fluid building up and swelling in the lungs and legs.
• Hypertrophic cardiomyopathy: The heart muscles become thicker, stiffening the left ventricle. Consequently, the ventricle is unable to fully relax, and its capacity to hold blood reduces.

After proper examination, cardiac surgeons decide whether the pacemaker should be placed directly into one of the heart’s four chambers or just under the clavicle (collarbone). It works by sending signals to the heart to regulate heart rate when it deviates from the normal range.

What are the Types of Pacemakers?

There are several types of pacemakers, each tailored to meet specific medical needs, and it can be categorised as:

Single-chamber pacemaker:  

A single-chamber pacemaker is employed when the right ventricle is not efficiently pumping low-oxygenated blood to the lungs. This pacemaker consists of only one lead, which is attached to the right ventricle of the heart. This lead carries electrical impulses to the chamber and ensures an average heart rate.

Dual chamber pacemaker: 

This pacemaker consists of two leads that carry electrical impulses to the right ventricle and right atrium of the heart and, hence, control the coordination between the two chambers. 

Biventricular pacemaker: 

This pacemaker is suggested for patients with heart failure or heartbeat problems. It stimulates and coordinates the ventricles of both sides of the heart.

Leadless pacemaker: 

This pacemaker requires no chest incision or visible pacemaker pocket and is implanted directly into the heart chamber. Since there is no lead involved, it dodges complications such as lead fracture, dislodgement, or infection.

What are the Key Factors That Affect the Pacemaker Surgery Cost in India?

Pacemaker surgery is often recommended for patients experiencing a loss of normal heart function. However, before proceeding with this life-saving intervention, a thorough examination of several critical factors is essential. These encompass the patient's overall health status, underlying cardiac condition, specific symptoms, medical history, and potential risks associated with the surgery. 

Some of the factors that affect the pacemaker surgery cost in India are listed below.

Type of pacemaker

Based on the heart condition of the patient, cardiac surgeons implement different pacemakers such as single chamber pacemaker, dual chamber pacemaker, dual chamber pacemaker which affects the cost for pacemaker surgery in India. The cost of leadless pacemaker for Indian patients ranges between INR 5,00,000 and INR 7,00,000. For international patients, it ranges from USD 12000 to USD 15000.

Hospital facilities and cardiac surgeon's expertise

Hospitals equipped with advanced amenities and renowned cardiac surgeons typically incur additional expenses. Moreover, the hospital's reputation and accreditation may impact the overall cost. The cardiac surgeon with more experience and better expertise in performing pacemaker surgery usually charges more. 

Additional stay at hospital/ICU

In specific medical situations, the patient might need to extend their ICU stay for additional days to receive post-operative care. Thus, the additional hospital stay costs around INR 12,000 and INR 20,000 (USD 250 to USD 300) on a per day basis.

What are Pre-surgical and Post-surgical Expenses in Pacemaker Surgery?

There are some tests to be performed for examination of patient’s health and follow-ups required afterwards which may add expenses to the overall surgery cost . It can be categorised into two:

• Pre-surgical examination cost (echocardiography, electrocardiogram, angiography, Holter monitor, stress testing etc.): INR 15,000 to INR 20,000 (USD 250 to USD 300)
• Post-surgery cost(monitoring pacemaker functioning, updating pacemaker software, medications etc.): INR 3,000 to INR 4,000 (USD 200 to USD 250)

What Should be the Post-surgery Care?

Since a pacemaker is a battery operated device inserted inside the most crucial organ of the body, it’s important to be extra careful as the function of the entire body depends on it. Hence, following considerations should be made post pacemaker surgery.

Physical activities restrictions

During the first few weeks, lifting the arm on the side at which the pacemaker has been attached is prohibited. Any strenuous exercise such as heavy lifting and playing sport should be avoided for 4-6 weeks. 

Avoid near contact with electronic devices

Some electronic devices still employ magnetic fields which interfere with the functioning of the pacemaker. 

Avoid therapies involving magnetic fields

Before going through any medical procedure such as magnetic resonance imaging (MRI), radiation therapy, shock-wave lithotripsy etc. medical professionals should be informed about pacemakers prior consultation.

Does Insurance Cover the Cost of Pacemaker Surgery in India?

In India, insurance agencies cover various surgical procedures, including pacemaker surgery. When your cardiologist recommends pacemaker implantation, your next step is to submit your doctor’s prescription, investigation reports, hospital admission papers to the insurance agency along with your policy papers. They will assess your claim eligibility and work with the hospital to cover your medical expenses as per policy terms.

Generally, health insurance policies may cover a portion or all of the expenses, including the cost of the pacemaker device, hospitalisation, surgeon fees, pre-surgery tests, and post-surgery care.

Hence, it's also crucial to understand the insurance's coverage scope and affiliated hospital network. Otherwise, you may need to bear the remaining costs yourself or use some alternative financial sources.