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 Pacemaker Implantation Surgery package cost in Spain varies from one hospital to another and may offer different benefits. The top hospitals for Pacemaker Implantation Surgery in Spain covers all the expenses related to the pre-surgery investigations of the candidate. The Pacemaker Implantation Surgery cost in Spain includes the cost of anesthesia, medicines, hospitalization and the surgeon's fee. Extended hospital stay, complications after the surgery or new diagnosis may affect the overall cost of Pacemaker Implantation Surgery in Spain.
There are many hospitals that perform Pacemaker Implantation Surgery in Spain. The top hospitals for Pacemaker Implantation Surgery in Spain include the following:
After discharge from the hospital, the patient has to stay for another 14 days in the country for complete recovery. This is important to ensure that the surgery was successful. During this time, control and follow-up tests take place to check for medical fitness.
While Spain is considered to be one of the best destinations for Pacemaker Implantation Surgery owing to the standard of Hospitals, and expertise of doctors; there are a select few destinations which provide comparable quality of healthcare for the procedure Some of the other popular destinations for Pacemaker Implantation Surgery include the following:
|South Africa||USD 12500|
|United Arab Emirates||USD 6000|
There are certain additional cost that the patient has to pay apart from the Pacemaker Implantation Surgery cost. The per day cost in this case may start from USD 50 per person.
There are many cities that offer Pacemaker Implantation Surgery in Spain, including the following:
There are several doctors who are available for telemedicine consultation for patients requiring Pacemaker Implantation Surgery in Spain. The following are some of the best doctors for Pacemaker Implantation Surgery in Spain who are available for video consultation:
|Doctor||Cost||Schedule Your Appointment|
|Dr. Juli Carballo||USD 833||Schedule Now|
|Dr. Antonio Berruezo||USD 833||Schedule Now|
|Dr. Xavier Ruyra Baliarda||USD 833||Schedule Now|
|Dr. Josep Brugada||USD 833||Schedule Now|
|Dr. Raul F Abella||USD 606||Schedule Now|
The patient has to spend about 3 days in the hospital after Pacemaker Implantation Surgery for proper recovery and to get clearance for discharge. 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 7 hospitals that offer Pacemaker Implantation Surgery in Spain. The above listed clinics are approved to perform the surgery and have proper infrastructure to handle Pacemaker Implantation Surgery patients. These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical association in Spain
The healthcare accredition in Spain is streamlined to maintain strict quality control over the hospital functions. The hospitals and healthcare centers in Spain are recognised to be of high quality on various parameters. The two parameters of healthcare quality and patient safety are checked by Joint Commission International in hospitals throughout Spain. The evaluators from the accrediting body in Spain are experienced and skilled healthcare professionals and their evaluation is trustworthy.
There is a good number of popular multispecialty hospital groups in Spain that are servicing patients from different hues and backgrounds for a long time. The hospitals in Spain are some of the best in the world and cover so many different specialties under individual roofs. We list here some of the best multispecialty hospitals in Spain.
Their is a good range of specialties covered by the multispecialty hospital groups in Spain that ensure that all your medical and surgical needs are taken care of.
The best and the latest technologies are adding to the world-class infrastructure in Spain. The skills and competence of doctors in Spain in treating different kinds of conditions is vouched for by the topmost healthcare professionals of the world. The universal cost coverage (excluding prescription drugs) or uni payer system gives an advantage to those wanting to get their treatment done in Spain. The world class medical facilities are combined with a great tourism potential in cities and towns of Spain and this is why you should opt for healthcare in Spain.Their is symbiotic relationship of wonderful tourist towns and cities with exceptional healthcare facilities, making Spain a natural choice as a medical tourism destination.
The doctors in Spanish hospitals have a good grasp of their field as they have gained knowledge from some of the best educational institutions in the world. Spain has a rich and vibrant healthcare community with doctors who have refined their skills as they have practical experience of several years. Whether it is learning new techniques or practical application of the new technologies, the doctors in Spain are adept at it all. It should be easy for you to get treated in Spain as the language barrier does not exist, you can converse with your doctor easily in english.
As you decide to travel to Spain, start by creating an essential document checklist. The documents that you carry must make the journey and treatment a seamless process during your medical tourism journey to Spain. Travel documents that are essential are financial means proof like bank statement, sponsorship letter, treatment payment proof or proof of your government covering the costs, employment documents (as per status) and passport, visa, roundtrip ticket, travel medical insurance, accomodation proof and civil status proof. Also, you must carry your medical documents such as medical reports, letter from the doctor/hospital referring you for treatment, correspondence between the doctor/hospital that referred you and the one where you are going to get treated and test reports.
Spain is an exclusive medical tourism destination like no other which is frequented by tourists the world over. The sporting culture in Spain makes sports medicine and orthopaedics a natural fit as both medical and surgical specialties in Spain. Please find here the most popular procedures done in Spain which have made it an advanced medical tourism destination. Plastic surgery, elective surgery, dentistry, eye care, bariatric surgery, orthopaedic procedures, spine surgery, sports medicine related procedures and fertility treatments.
The vaccinations before you head to Spain as a medical traveller are not just essential but mandatory as well. There are conditions such as Diphtheria-Tetanus-Pertussis, Flu (Influenza), Measles-Mumps-Rubella (MMR), Polio and Chickenpox (Varicella) for which vaccinations are taken on a routine basis. Vaccinations for Measles, Hepatitis A and Hepatitis B are taken by travellers who are at a higher health risk. Other conditions for which you must take vaccinations before heading to Spain are Meningitis, Shingles, Pneumonia, Covid19 and Rabies.
Hospitals provide a lot of additional facilities to assist medical travellers in their treatment in Spain. In line with this endeavour, international patient services are available in major hospitals in Spain. As a medical traveller, one positive is the opportunity of availing private healthcare insurance in hospitals in Spain. Hospitals in Spain provide many additional facilities as well such as:
Spain is well known for its various medical tourism destinations such as
Among these destinations, Madrid healthcare is synonymous with reproductive health services and general healthcare and Barcelona is famous for child healthcare hospitals. Medical tourism is a key focus area in Spain and investments are being planned and implemented to bring this about. Medical tourists are also coming to spain because of its outstanding healthcare infrastructure which is being updated regularly with the best of technologies.
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