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.
Pacemaker Implantation Surgery package cost in Greece has different inclusions and exclusions. The top hospitals for Pacemaker Implantation Surgery in Greece covers all the expenses related to the pre-surgery investigations of the candidate. The comprehensive Pacemaker Implantation Surgery package cost includes the cost of investigations, surgery, medicines and consumables. Extended hospital stay, complications after the surgery or new diagnosis may affect the overall cost of Pacemaker Implantation Surgery in Greece.
After Pacemaker Implantation Surgery in Greece, the patient is supposed to stay in guest house for another 14 days. This period is important to conduct all the follow-up tests to ensure that the surgery was successful and the patient can go back to the home country.
Greece is undoubtedly one of the best countries for Pacemaker Implantation Surgery in the world. It offers the best medical expertise and good patient experience at an affordable cost. Some of such countries are:
|South Africa||USD 12500|
|United Arab Emirates||USD 6000|
Apart from the cost of Pacemaker Implantation Surgery, the patient is also required to pay additionally for daily meals and guest house accommodation. The extra charges may start from USD 50 per person.
Some of the cpopular cities in Greece that offer Pacemaker Implantation Surgery include the following:
The patient is supposed to stay at the hospital for about 3 days after Pacemaker Implantation Surgery for monitoring and care. During the recovery, the patient is carefully monitored and control tests are performed to see that everything is okay. If required, physiotherapy sessions are also planned during recovery in hospital.
There are more than 3 hospitals that offer Pacemaker Implantation Surgery in Greece. These hospitals have propoer infrastructure as well as offer good quality of services when it comes to Pacemaker Implantation Surgery Such hospitals follow all legal protocols and guidelines as specified by the local medical affairs body when it comes to the treatment of international patients.
The most popular hospitals in Greece are:
Greece has world-class hospitals that strictly follow international health standards and are backed by internationally accredited physicians. Some of the popular destinations like Corfu, Peloponnese, Crete, Thessaloniki, Alexandroupolis, Kalamata, and Athens are flocked with the majority of hospitals, which help in the growth of medical tourism in the country.
Joint Commission International (JCI) is the main healthcare accreditation body in Greece. The JCI standards are developed in consultation with global healthcare experts and providers, as well as patients. Hospitals in Greece have to undergo a lengthy process to get accreditation from JCI. They need to meet all the mandatory criteria set by the organization. Healthcare standards let hospitals control, evaluate, and improve the standards of quality healthcare.
One of the leading destinations for medical tourists, Greece attracts thousands of overseas patients seeking the best care at competitive prices. Well known for its excellent medical services, Greece is recognized throughout Europe and the U.S. for its top-quality medical facilities that follow international healthcare standards. Besides offering world-class treatment, Greece also provides a great patient experience through unique Mediterranean cuisine, beautiful landscape, and therapeutic natural springs. Other factors that have improved Greece’s presence in the wellness tourism market are excellent private healthcare services, availability of world-renowned as well as highly trained medical professionals, and technologically-driven medical care.
Greece produces high-quality specialist doctors. According to a report, about 95 percent of doctors in the country are specialists. Around 95 percent of doctors in Greece are specialists and are not restricted to only general medicine. Also, the majority of the doctors have received training in different countries and capable of handling even the most complex cases with quite an ease. Producing one of the finest doctors in the world, Greece has stringent government regulations for doctors in order to ensure best practices. Also, every doctor must at least 80 hours of training every five years. There are many exemplary achievements of doctors in Greece, such as doing the first transcatheter closure of a patent ductus arteriosus, successful excision of cancerous cells in an inaccessible and sensitive area of the brain, and performing the first live-streamed global interactive rhinology and endoscopic skull base surgery.
A person needs to apply for the below two types of visa to seek treatment in Greece:
A person holding a Schengen Visa can stay in Greece for a period of 90 days within a period of six months. Here is the list of important documents that you will require when applying for a medical visa:
Depending on the interview and the documents submitted, the Greece embassy decides whether a person can be granted a medical visa or not.
Greece has received worldwide recognition for reporting high success rates in the following procedures:
Also, Greece attracts a large number of people seeking renal dialysis. Many state-of-art dialysis centers are present all across the country. Around 300,000 cosmetic procedures are performed annually in Greece. The reasons for the popularity of plastic surgery in the country are the use of modern technology, highly trained plastic surgeons, and the latest innovations. Greece is a very popular country for IVF treatment and there are at least 50 IVF clinics in the country. People travel from overseas for egg donation and embryo donation.
The cities in Greece which have received worldwide recognition for medical tourism are: 1. Athens 2. Kalamata 3. Peloponnese 4. Alexandropoulos 5. Thessaloniki 6. Corfu 7. Athens
Athens is the epicenter of the medical travel industry in Greece where patients seek high-standard medical services in various disciplines like cosmetic surgery, gynecology and obstetrics, orthopedics, and rehabilitation. One of the most visited islands in Greece, Santorini is medical tourist heaven due to its excellent scenic value which helps in the speedy recovery of patients through relaxation and rejuvenation. State-of-art hospitals, transportation facilities, affordable accommodation, a wide variety of food options, and language assistance are some other reasons why these cities are top-ranked medical tourist destinations.
Yes, a person needs to get vaccinated before traveling to Greece. Below is a list of vaccines suggested by the CDC and WHO:
Some parts of Europe are affected by periodic outbreaks of routine diseases, hence it becomes essential for a traveler to get immunized. You should seek travel health advice related to your personal needs and your intended travel, including anti-malarial and other medications based on the past vaccination history, advice on vaccinations, and your present medical conditions. Connect with the government or contact your hospital in Greece to get complete information on vaccination.
MediGence has pre-negotiated bundled pricing for many surgical procedures that helps you save cost and avail unmatched benefitsExplore our Best Offers
Ask your healthcare adviser for the best multiple options and choose the one that meets your expectations
(+1) 424 283 4838