Pacemaker implantation is a common surgery and it significantly improves the quality of life led by the patient. The blood-pumping organ, heart, is essentially made of a few groups of muscles. These muscles are controlled by electrical signals to ensure that the heart beats naturally and effectively to circulate blood to all parts of the body. When this electrical signal gets disrupted due to some reason, then an individual may experience tachycardia (where hear beats abnormally slow), heart block, arrhythmia (irregular heartbeat), or a cardiac arrest (abrupt and sudden stopping of the heartbeat).
The contractions happen as a result of triggered electrical pulses generated by sinoatrial node or the SA node. It acts like a pacemaker of the heart. This electrical pulse is then sent to the atrioventricular node or the AV node for relaying the pulse to the ventricles. Pacemaker implantation is suggested when this electrical signaling network is disrupted.The faulty functioning of the natural pacemaker of the heart may lead to the following:
Sick sinus syndrome: It is characterized by a slow heartbeat (bradycardia) or fast heartbeat (tachycardia) or a combination of both. It can happen due to age, a previous history heart attack, and thyroid problem, too much of potassium accumulation in blood, heart surgery, or sleep apnea.
In this case, the impulse is either delayed or absent.
The heart can stop beating. It may result because of the presence of coronary artery disease and muscle problems in the heart, which can happen after the age of 35.
Some of the symptoms observed in patients requiring pacemaker implantation are:
A pacemaker implant is a small device that weighs around 20 g to 50 g and is the size of a matchbox. It has a pulse generator with a battery, a tiny computer circuit and a few wires called pacing leads. This system is attached to the heart and it emits signals through the wires. The pacing rate or the rate of electrical impulses can be adjusted as per the requirement of the body and be accordingly programmed. It can sense if a heartbeat is missed or if the heart is beating too slow. Accordingly, it starts sending a steady signal to normalize the beating of the heart. If the beats are normal, then it simply does not send any signal.
Insertion of a permanent pacemaker is a minimally invasive procedure. Access to heart chambers takes place as transvenous access to local anaesthesia. The most common method is via the subclavian vein or the cephalic vein. In rare cases, it is through femoral vein or the internal jugular vein. Either in an operating room or in a cardiac catheterization laboratory, the pacemaker implant procedure is performed.
In the infraclavicular region, the pacing generator is placed subcutaneously. Via thoracotomy, the pacemaker leads are implanted surgically. The pacing generator is then placed in the abdominal area. Either via left or right pectoral sites, single chamber and dual chamber insertion can be accomplished. The chest is then prepared. Sterile drapes are applied to the incision area to keep it as sterile as possible. Antibiotic prophylaxis is nowadays employed for the implantation. Preoperative antibiotic can reduce the chances of any infection by almost 80 percent. Cefazolin 1g is administered intravenously one hour prior to the procedure. Other antibiotics can be administered if the patient is allergic to cephalosporins, vancomycin, or penicillins.
The central vein is accessed percutaneously. Due to skeletal landmarks being deviated in some patients, there will be a need of fluoroscopic examination to reduce the time and complications in access. At the junction of first rib and the clavicle, the subclavian vein is typically accessed. For the confirmation of deep vein thrombosis, a phlebography is required for visualization of the vein.
Now a guide wire is advanced through the access needle and tip of the guide wire in placed in the right atrium or venacaval area under fluoroscopy. The guide wire is kept in place after the needle is withdrawn. If required, a second guide wire is also placed. Double wire technique may be employed through a sheath which is then withdrawn. Two separate sheaths can be manoeuvred over the two guide wires. During the lead advancement, some friction can be felt.
An incision of one to two inches is made in the area of the infraclavicle, which is parallel to the middle third of the clavicle and a subcutaneous pocket is made with both sharp and blunt dissection. This is for the implantation of the pacemaker generator. In many cases, surgeons prefer the access later and pocket first.
A peel-like special sheath and dilator are advanced over the guide wire. The guide wire and dilator are withdrawn keeping the sheath in place. A stylet is then inserted in the center channel of the pacemaker lead making it more rigid. This lead-stylet combination is then inserted into the sheath and advanced to the concerned heart chamber under fluoroscopy. In order to prevent dislodgement, the ventricular lead is positioned before the atrial lead. For the positioning in the tricuspid valve, a small curve at the tip of the stylet make it more mobile to reach the right ventricular apex. The introducing sheath is peeled once the lead is secured. With a pacing system analyser, the lead impedances are measured after the pacing lead stylet is removed. To prevent diaphragmatic stimulation, the pacing is performed at 10V.
After the confirmation of thresholds and lead position, the proximal end of the lead is secured to the pectoralis tissue with the help of a non-absorbable suture. This suture is sewn to a sleeve which is located on the lead. This is placed in the right atrium is a second lead is required. For patients who have already had a cardiac surgery, the lead tip is positioned medially or in the free lateral wall of right atrium. Same process of stylet withdrawal is followed after this. After positioning and testing of leads, the pacemaker pocket is fed with antimicrobial solution and the pulse generator is connected to the leads. To prevent migration or twiddler syndrome, many surgeons secure the generator to the underlying tissue with non-absorbable suture.
Before final confirmation of lead positioning, a look is taken under the fluoroscope. With the help of adhesive strips and absorbable sutures, the incision is closed. A sterile dressing is then applied on the surface. To limit movement for 12 to 24 hours, an immobilizer or arm restraint is applied. The chances of pneumothorax are ruled out with the help of a postoperative chest radiograph.
Usually, a patient is kept under observation for more than a day after the pacemaker implantation surgery. It takes around six weeks before the patient to get used to the implanted device. Heavy works must be avoided initially. One should ensure that the concerned arm is not rendered immobile during this time to prevent a frozen shoulder. A physiotherapist can exactly show the movements that you need to perform to keep your arm healthy. Carry the duly filled pacemaker implant card for emergency to avoid any unwanted situation.
On an average, Pacemaker Implantation Surgery in Czechia costs about $6000. In Czechia, Pacemaker Implantation Surgery is conducted across many multispecialty hospitals.
The Pacemaker Implantation Surgery package cost in Czechia varies from one hospital to another and may offer different benefits. The Pacemaker Implantation Surgery package cost usually includes all the expenses related to pre and post surgery expenses of the patient. The Pacemaker Implantation Surgery procedure in Czechia includes the fees of the surgeon, hospitalization and anesthesia as well. Stay outside the package duration, post-operative complications and diagnosis of a new condition may further increase the Pacemaker Implantation Surgery cost in Czechia.
Many hospitals in Czechia perform Pacemaker Implantation Surgery. For quick reference, the following are some of the leading hospitals for Pacemaker Implantation Surgery in Czechia:
While the speed of recovery may vary from patient to patient, they are still required to stay for about 14 days after discharge. During this time, the patient undergoes medical tests and consultations. this is to ensure that the treatment was successful and the patient us safe to return.
Czechia is considered to be one of the best places for Pacemaker Implantation Surgery in the world. This is because of the availability of some of the best doctors, advanced medical technology and good hospital infrastructure. Some of the other destinations that are popular for Pacemaker Implantation Surgery include the following:
|South Africa||USD 12500|
|United Arab Emirates||USD 6000|
Apart from the Pacemaker Implantation Surgery cost, the patient may have to pay for additional daily expenses such as for guest house after discharge and meals. The extra charges may start from USD 50 per person.
There are many cities that offer Pacemaker Implantation Surgery in Czechia, including the following:
After Pacemaker Implantation Surgery, the patient is supposed to stay for about 3 days in the hospital for recovery and monitoring. The doctors team review the patient's recovery during this time with the help of blood tests and imaging scans. Once they feel that everything is on track, the patient is discharged.
There are more than 1 hospitals that offer Pacemaker Implantation Surgery in Czechia. The above mentioned clinics have the required infrastructure and a dedicated unit where patients can be treated. Also, these hospitals follow the necessary guidelines as required by the medical associations for the treatment of Pacemaker Implantation Surgery patients.
The Joint Commission International accredites hospitals and clinics in Czechia. It is a body which is present in over 100 countries. The JCI is a not for profit organisation which ensures that the standards of healthcare and patient safety are maintained for the healthcare system in Czechia. Joint Commission International is the body that has partnered with several healthcare organisations in Czechia to ensure that they maintain quality in healthcare. A Joint Commission International certification is a guarantee that standards of organisation management or the best care of the patients is ensured in any hospital or clinic in Czechia.
We are listing here the popular multispecialty hospitals in Czechia for your convenience::
There are several advanced multispecialty hospitals in Czechia which are the backbone of the healthcare sector in Czechia and it is them which make Czechia the popular medical tourism destination it is today. Any patient can get the treatment they deserve in any specialty at an economical price in the multispecialty hospitals in Czechia. The popular multispecialty hospitals in Czechia are constantly upgraded with the latest technologies to keep up the high degree of healthcare available.
The stringent framework that defines the healthcare system in Czechia is the reason that you should opt for healthcare in Czechia. It is also why many entities such as private organisations, governments, patients, academicians, patients, healthcare professionals are confident of healthcare systems in Czechia. You must opt for healthcare in Czechia as the treatment options available in the hospitals and clinics in Czechia are at affordable prices. This is in addition to the wide variety of treatments being performed here everyday. Medical travellers to Czechia are aware of the high standards of healthcare and their continuous maintenance and this is a really good reason for you to opt for healthcare in Czechia as well. Do opt for healthcare in Czechia like the numerous medical tourists heading to Czechia every year because the country has high standards of healthcare which are being sincerely maintained.
The good quality of doctors in Czechia can be ascertained from the fact that not only are they educated from the best universities in the world but have years of on field training and experience in their expertise. The quality of treatment given and procedures performed by the doctors in Czechia are synonymous with high success rates. The good quality doctors in Czechia are definitely world renowned for their immense contribution to the medical field. The doctors in Czechia make sure that the patients’ entire treatment process is completed with efficiency right from the consultation to the post operative care.
The essential documents that you need to carry for your medical treatment journey to Czechia are:
The documents that you are carrying for your medical travel to Czechia are related to your travel and treatment. Your finances must be in order too to support your medical travel, if not then be assured of sponsorship and insurance options and do carry the relevant documents for the same. You must carry travel and treatment related documents on your medical travel to Czechia. The documents that show that your finances can support your treatment need to be carried with you as well (either self financing or through sponsorship and insurance). If you have your essential documents ready, your medical tourism journey to Czechia will be hassle free and seamless.
Let us have a look at the various popular procedures that are being done in Czechia:
The trend of losing weight surgically is drawing a lot of medical travellers to Czechia as well with procedures such as Sleeve Gastrectomy and Gastric Bypass becoming more popular each year. Knee replacement and Hip replacement are two orthopaedic procedures which are increasingly driving more and more medical travellers to the hospitals in Czechia. This has happened because of the strides that Orthopaedics has made as a medical specialty in Czechia. Among the popular procedures being performed in Czechia, Microdiscectomy and Spinal Fusion are a sign of the strong spinal surgery base in the hospitals in the country.
Please make sure that you are well prepared before your travel to Czechia and have protected yourself with the right vaccinations as it is essential to do so. Here are the vaccinations that are a must for any medical traveller who is headed to Czechia for their treatment:
Among the vaccinations that are to be taken before your Czechia medical trip are those that are routine and those basis age specifics and potential health hazards. You can recheck the required vaccinations before your travel to Czechia with the World Health Organisation, a United Nations arm and Centers for Disease Control and Prevention, a US agency.
Let us have a look at the many additional facilities that hospitals in Czechia present to patients and their companions and we present some of them here for you:
All the major hospitals in Czechia are at the forefront of management of international patients’ facilities since several years and this is accomplished by thorough healthcare and administration professionals manning the international patient care facilities. When you come to get your medical treatment for your condition in any major hospital in Czechia, you will need to liaison with only a single point of contact who will ensure that your international, local travel and hospital transfer is made seamless. This is a great facility that is available for all medical travelers to Czechia. There are many kinds of add on facilities that are available in hospitals in Czechia such as laboratories, pharmacies and physiotherapists.
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