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 cost in Lebanon varies from one hospital to the other. The top hospitals for Pacemaker Implantation Surgery in Lebanon covers all the expenses related to the pre-surgery investigations of the candidate. Typically, the package cost of Pacemaker Implantation Surgery in Lebanon includes the expenses related to the surgeon's fee, anesthesia, hospital, meals, nursing and ICU stay. Post-surgical complications, new findings and delayed recovery may have an impact on the total Pacemaker Implantation Surgery cost in Lebanon.
Upon discharge from the hospital after Pacemaker Implantation Surgery in Lebanon, the patients are advised to stay for about 14 days for recovery. This time frame is important to ensure that the surgery was successful and the patient is fit to fly back.
Lebanon 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 popular destinations for Pacemaker Implantation Surgery include the following:
|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 per day cost in this case may start from USD 50 per person.
Some of the cpopular cities in Lebanon that offer Pacemaker Implantation Surgery include 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 2 hospitals that offer Pacemaker Implantation Surgery in Lebanon. Such clinics have the required infrastructure and a dedicated unit where patients can be treated. 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 hospitals in Lebanon seek to get accredited from Joint Commission International or JCI, an international body present in over 100 countries. We bring to you the JCI certified hospitals and medical centers in Lebanon.
It is the maintenance of quality standards and striving continuously for performance improvement that is also the aim of Joint Commission International in relation to the health organisations. The Joint Commission International accreditation can also be considered as the gold seal of approval for healthcare providers and academic medical centers in Lebanon.
We present to you a number of multispecialty hospitals in Lebanon:
The various specialties covered in the multispecialty hospitals in Lebanon are
A great combination of providing the best in patient care and a holistic medical treatment experience to the patients, multispecialty hospitals in Lebanon are a class apart. Healthcare professionals responsible for patient care in the multispecialty hospitals in Lebanon are reaching newer heights in their field of expertise.
It makes sense for you to choose to get healthcare in Lebanon because of its immensely inspirational healthcare providers who leave no stone unturned in ensuring good health for people. The involved decision making process that healthcare providers in Lebanon follow by ensuring that the patients are made aware of all their options and have intricate knowledge of their treatment journey is reason enough for you to choose to get your healthcare from Lebanon. If you choose to get your healthcare from Lebanon you will have access to the excellent specialised clinical programs and services units in the hospitals here which helps you get the treatment you need despite challenges. Please do opt to get your healthcare from Lebanon because of their focus on improving their healthcare infrastructure which will reflect on the quality of healthcare you are going to get in hospitals in Lebanon.
The quality of doctors in Lebanon is unmatched owing to the fine training they receive from experts, the excellent education standards and their dedication to medicine. As healthcare professionals, the doctors in Lebanon are extremely knowledgeable and their ability to overcome new healthcare challenges to give the best of medical treatment makes them great doctors. The new medical research is learnt and applied quickly and with ease by the doctors in Lebanon ensuring the best of medical treatment at hand to patients. Whether it be the experience of treating international patients or first hand knowledge of the best treatment methods available anywhere in the world, the doctors in Lebanon always come ahead.
We bring to you the essential documents that are required when you go to Lebanon to get treated.
As you begin your medical travel to Lebanon, make sure that you have all your documents ready to make your journey and medical treatment process seamless and effortless. As you are preparing for your medical travel to Lebanon make sure that your medical treatment related documents and those supporting your financial preparedness or sponsorship details are ready. As you tally the required travel and treatment documents for your medical travel to Lebanon, preparing a checklist makes it easier to not miss out on anything.
Here are the popular procedures being performed in Lebanon:
With surgical weight loss procedures such as Gastric bypass and Sleeve gastrectomy attracting a lot of medical travellers to Lebanon, we can conclude that these are popular procedures in Lebanon. Cancer related treatments such as Chemotherapy is being done with high success rates for medical travellers in the hospitals in Lebanon. Lap hernia repair, a minimally invasive procedure is quite a popular procedure among medical travellers coming to Lebanon.
Please know that it is important to be vaccinated as you plan your medical travel to Lebanon, even Centers for Disease Control and Prevention, US government body and World Health Organisation, a United Nations agency say so. We have listed here the mandatory vaccinations as you head to Lebanon.
Prior to your medical travel to Lebanon, please get these recommended vaccines Typhoid, Hepatitis A and B, MMR (one dose before travel irrespective of the routine vaccine for infants) and Rabies. Vaccinations help prevent you from getting potential ailments and whether mandated by any authority or not, it is always advisable to take them before your Lebanon travel.
Thereare several additional facilities provided by the international patient services office present in the hospitals in Lebanon such as:
It is prudent to understand that even prior to reaching Lebanon, you can pre plan your visit by reserving online and getting pre-admission done in the wonderful multidisciplinary hospitals in Lebanon. Please see some more facilities that make your treatment and stay comfortable in the hospitals in Lebanon.
It is the patient centric approach that defines the facilities present for every patient in the hospitals in Lebanon.
It is factors such as services quality, nature of facilities, destination environment, medical tourism industry that have put Lebanon in the list of 46 nations of the 2020-21 Medical Tourism Index. Over hundred year legacy of Lebanon as a medical tourism destination has been regained in the past several years and is further on the verge of growth. Please find medical tourism destinations in Lebanon listed below:
Beirut, Lebanon’s capital city is known not just for its healthcare centers but also for its tourism potential and is clearly a major medical tourism destination in the middle east.
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