14
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11 Days Outside Hospital
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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.
| Package Name | Cost | Book Package |
|---|---|---|
| Pacemaker Implantation Surgery in Indraprastha Apollo Hospital, Delhi, India | 8615 USD | Book Now |
Pacemaker Implantation Surgery package cost in Hungary has different inclusions and exclusions. Some of the best hospitals for Pacemaker Implantation Surgery offer a comprehensive package that covers the end-to-end expenses related to investigations and treatment of the patient. Typically, the package cost of Pacemaker Implantation Surgery in Hungary includes the expenses related to the surgeon's fee, anesthesia, hospital, meals, nursing and ICU stay. A prolonged hospital stay due to delayed recovery, new diagnosis and complications after surgery may increase the cost of Pacemaker Implantation Surgery in Hungary.
Pacemaker Implantation Surgery in Hungary is offered by multiple hospitals across the country. For quick reference, the following are some of the leading hospitals for Pacemaker Implantation Surgery in Hungary:
After discharge from the hospital, the patient has to stay for another 14 days in the country for complete recovery. This time frame is important to ensure that the surgery was successful and the patient is fit to fly back.
Hungary is one of the most popular countries for Pacemaker Implantation Surgery in the world. The country offers the best cost of Pacemaker Implantation Surgery, best doctors, and advanced hospital infrastructure. However, there are other countries as mentioned below that are popular for Pacemaker Implantation Surgery as well:
| Country | Cost |
|---|---|
| Czechia | USD 6000 |
| India | USD 4500 |
| Israel | USD 12500 |
| Lithuania | USD 11500 |
| Malaysia | USD 7500 |
| Poland | USD 5000 |
| South Africa | USD 12500 |
| Thailand | USD 14500 |
| Tunisia | USD 3600 |
| Turkey | USD 9000 |
| United Arab Emirates | USD 6000 |
There are certain expenses additional to the Pacemaker Implantation Surgery cost that the patient may have to pay for. These are the chanrges for daily meals and hotel stay outside the hospital. The per day cost in this case may start from USD 50 per person.
There are many cities that offer Pacemaker Implantation Surgery in Hungary, including the following:
After the Pacemaker Implantation Surgery takes place, the average duration of stay at the hospital is about 3 days. This phase is important to ensure that the patient is recovering well and is clinically stable. During this time, several tests are performed before the patient is deemed suitable for discharge.
There are more than 1 hospitals that offer Pacemaker Implantation Surgery in Hungary. The above listed clinics are approved to perform the surgery and have proper infrastructure to handle Pacemaker Implantation Surgery patients. Apart from good services, the hospitals are known to follow all standard and legal guidelines as dictated by the local medical affairs body or organization.
Some of the most sought after medical specialists for Pacemaker Implantation Surgery in Hungary are:
FalseA good number of patients’ lives are becoming healthier with the superior treatment being provided to them by exceptional medical and surgical specialists working with the latest technologies in the multispecialty hospitals in Hungary. Please find below well known multispecialty hospitals in Hungary:
A wide range of specialties are offered in the multispecialty hospitals and clinics in Hungary which enables both straightforward procedures and complex procedures. When we talk of the multispecialty hospitals in Hungary, they are always identified with their willingness to go to extra lengths which result in brilliant outcomes and satisfied patients.
It is the latest technologies combined with the best in the world medical and surgical specialists that is taking healthcare in multispecialty hospitals in Hungary to greater heights everyday. Hungary remains a good choice to get healthcare from as their is good quality care being provided to patients and focus on precision in the execution of procedures. The healthcare ecosystem in the Hungary is research based and provides ample opportunities to the patients to explore their options within the country’s healthcare framework. Hungary is the natural choice to get your healthcare from as the exceptional safety and comfort any patient experiences here is several notches higher than several popular medical tourism destinations.
The great quality of doctors in Hungary is a testament to their collaborating ability with the larger international doctor community of the world ensuring knowledge sharing and excellent results. Education from the topmost universities of the world, being exceptionally skilled at their job ensures that the doctors in Hungary are of good quality. The doctors in Hungary keep abreast of the latest developments in the medical and surgical fields and work as a team player with their fellow medical practitioners and with the patients to give the best results. The strength that the doctors in Hungary possess is a wonderfully diverse patient pool, giving them the advantage of interacting with and providing healthcare solutions to international patients on a daily basis.
Please find below the essential documents that you must carry when traveling to Hungary:
We are outlining the three different types of documents that you need for your travel to Hungary and these are travel related, strength of your finances and related to your medical treatment The medical tourism journey to Hungary is a smooth ride for those who make sure to carry all their essential medical travel documents with them. Your medical travel to Hungary must be supported and prescribed by the right authorities and it is important that you prepare documents as per your checklist.
Let us have a look at the procedures that are popular in Hungary:
There are several popular procedures done in Hungary but orthopaedics can be safely said to be the most popular medical and surgical specialty as the most frequently performed procedures are from this specialty. The strengths of healthcare in Hungary are its excellent healthcare infrastructure and its expert specialists because of which the procedures being performed here are a huge draw for medical travellers the world over. There is a lot of advancement in the techniques applied in procedures such as Hip Replacement, Knee Replacement and Shoulder Arthroscopy making them some of the most popular procedures being performed in Hungary.
Please update yourself about the required vaccinations before your visit to Hungary and get vaccinated atleast a month before your travel when you visit your doctor We bring to you the important routine vaccinations that must be taken before you start your journey to Hungary.
Please find below the vaccinations that are differentiated as per age and for people with potential health hazards.
Please be extra careful before your travel to Hungary by reconfirming the vaccinations that your doctor has suggested with the ones mentioned by the CDC or Centers for Disease Control and Prevention and WHO or World Health Organisation.
There are several facilities that are available to medical travellers other than the ones related to your core medical treatment in the hospitals in Hungary. The hospitals in Hungary are giving you a 360* healthcare experience by presenting several additional facilities as listed below:
The doctors in the hospitals in the multispecialty hospitals in Hungary are available for online and video consultation when required, this facility makes it easier for patients to assess and make the right decision on their treatment. The whole process of two way travel, transfer, accommodation and treatment is streamlined in the multispecialty hospitals in Hungary because of excellent international patient coordination.
The absolutely good service quality and outstanding facilities has led Hungary to a rank of 23 out of 46 world destinations in the 2020-21 Medical Tourism Index. We bring to you the various medical tourism destinations in Hungary:
In Hungary, there are places like Csongrad county, Debrecen, Pecs and Szeged which have found a spot as the best medical tourism destination in the country.
Documents needed for Medical treatment (Schengen visa type C) to Hungary are as follows.
When planning your medical travel to Hungary, kindly make sure whether you require the Schengen visa or not to enter Hungary. There are reasons behind the kind of documents expected from you for the visa application:
It takes two weeks for a medical visa to be granted and it is for a stay in Hungary for 90 days or less. For any longer time period please apply for National Visa for Medical Treatment.
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