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.
The average cost of Pacemaker Implantation Surgery in Israel starts from USD 12500 Many multispeciality hospitals which are JCI certified are approved to operate a Pacemaker Implantation Surgery in Israel
The Pacemaker Implantation Surgery package cost in Israel varies from one hospital to another and may offer different benefits. There are many hospital that cover the cost of pre-surgical investigations of the patient in the treatment package. Typically, the package cost of Pacemaker Implantation Surgery in Israel includes the expenses related to the surgeon's fee, anesthesia, hospital, meals, nursing and ICU stay. There are many things that may increase the cost of Pacemaker Implantation Surgery in Israel, including prolonged hospital stay and complications after the procedure.
Many hospitals in Israel perform Pacemaker Implantation Surgery. The following are some of the most renowned hospitals for Pacemaker Implantation Surgery in Israel:
After Pacemaker Implantation Surgery in Israel, the patient is supposed to stay in guest house for another 14 days. 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.
Israel 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 Pacemaker Implantation Surgery cost, there are a few other daily charges that the patient may have to pay. These are the charges for daily meals and accommodation outside the hospital. The extra charges may start from USD 50 per person.
Some of the best cities in Israel which offer Pacemaker Implantation Surgery are:
The average duration of stay at the hospital after Pacemaker Implantation Surgery is about 3 days for proper care 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 6 hospitals that offer Pacemaker Implantation Surgery in Israel. These clinics have proper infrastructure for the treatment of patients who require kidney transplant. These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical association in Israel
The healthcare system in Israel is accredited by The Joint Commission International (JCI). JCI is an independent organization that accredits and certifies healthcare organizations across the globe. Hospitals in Israel are committed to adhering to international healthcare standards and medical protocols in order to ensure quality treatment and complete patient safety. The standards offer a comprehensive corrective action plan for ensuring quality culture at all levels and across all functions.
The best multispecialty hospitals in Israel are:
All kinds of surgeries are offered at these multispecialty hospitals and they follow strict medical protocols. Highly skilled and trained doctors at these hospitals are efficient to handle even the most complicated cases. The hospitals provide world-class treatments at an affordable cost.
Israel is a leading destination for medical tourism which attracts thousands of medical tourists every year. Israel is a well-acclaimed destination for medical tourists who receive world class treatment. A large number of patients visit Israel from different parts of the world, including the United States, and Nigeria, Russia, Ukraine, Cyprus, Kazakhstan, Georgia, Bulgaria, Romania, Hungary. Several other factors contribute to the popularity of Israel in medical tourism, including the best medical infrastructure, highly qualified doctors, cheap accommodation, transportation facilities, and a wide range of food choices.
Board-certified doctors have the ability to practice at the top of their profession and also ensure high-quality care to their patients. Israel has world-class doctors that have in-depth subject knowledge, and their area of expertise is really vast. The doctors in Israel are highly qualified because they receive quality education at premier institutions. The quality of doctors and medical staff in Israel is very good and most of these doctors have exposure of working in different parts of the world.
The documents that you need to carry when traveling to Israel for medical treatment are medical History, passport copies, residence/ driver’s license/ bank statement/ details of Health insurance, test reports, records, doctor referral notes. Once you have all the required set of documents, receiving medical treatment in Israel becomes very easy. Packing is crucial when you are traveling to another country for seeking medical treatment since you may miss some important documents. The documents needed may differ as per your destination, so please check with the concerned authority before traveling.
Some of the popular procedures performed in Israel have received worldwide recognition, such as:
The success of the popular procedures is supported by the use of advanced medical technology and highly skilled and well-qualified doctors who perform the procedures with great care and accuracy and ensure fast recovery, complication-free surgery, and complete patient safety. A unique technology has been introduced in Israel to perform hernia surgery with few complications and fast recovery, and the country has also reported huge success in bone implants through tissue engineering technology. Israel has reported outstanding results with Botox injection and hair implantation with a huge success rate.
Some of the most popular cities in Israel that attract a large number of medical tourists every year are:
The excellent cultural diversity and natural beauty of these cities make them the perfect destinations for medical tourists, contributing to the overall well-being and speedy recovery. The cities boast of having the best hospitals in Israel with state-of-art infrastructure, world-class doctors, a wide range of facilities, and affordable treatment. Many other reasons that make these cities the most preferred destination for medical tourism are affordable accommodation, transportation facilities, a variety of food options, and scenic value.
To make patient’s hospital stay memorable, healthcare facilities in Israel offer all modern facilities, such as visa assistance, travel arrangements, airport transfers, coordination of all medical appointments, accommodations for patients and companions, international staff translators, shopping and recreational options, Internet with wi-fi, mobile sim cards, lockers, and a variety of food options. The hospitals provide all necessary facilities that are affordable and at par with international standards in order to provide a unique patient experience. The well-trained staff at hospitals guide patients by connecting with doctors, provide cost estimates, and schedule appointments that meet patients’ travel dates.
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