A pacemaker is a special device that is implanted in the chest of cardiac patients suffering from abnormal heart rhythm. This device uses low-energy pulses to prompt the heart whenever it senses a difference in the heart rhythm. Arrhythmias (bradycardia or tachycardia) are the problems associated with the rhythm of the heart. The fluctuation if heartbeat may pose a serious threat to the life of the patients if left untreated for long.
Thailand has emerged as one of the most popular medical tourism destinations in the world. The country is not just famous for its exotic tourist spots, but equally famous for its experienced medical fraternity and the quality of treatment offered by the best hospitals in the country. It is especially known for its use of cardiac treatment technology. Thousands of patients from across the world travel to Thailand to undergo cardiac treatment procedures and the numbers just keep on increasing with each passing year.
Pacemaker implant cost in Thailand depends on the experience of the surgeon conducting the surgery and the type of hospitals that you have selected to undergo treatment at. Additionally, it depends on the total duration of hospital stay, the type of room opted for, and the level of services availed during the stay in the country.
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 Thailand starts from USD 14500 Pacemaker Implantation Surgery in Thailand is conducted across several Healthcare Accreditation Institute, JCI certified hospitals.
Pacemaker Implantation Surgery package cost in Thailand has different inclusions and exclusions. The Pacemaker Implantation Surgery package cost usually includes all the expenses related to pre and post surgery expenses of the patient. The Pacemaker Implantation Surgery cost in Thailand 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 Thailand.
Many hospitals in Thailand perform Pacemaker Implantation Surgery. The following are some of the most renowned hospitals for Pacemaker Implantation Surgery in Thailand:
After Pacemaker Implantation Surgery in Thailand, the patient is supposed to stay in guest house for another 14 days. This time frame is important to ensure that the surgery was successful and the patient is fit to fly back.
While Thailand 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 However, there are other countries as mentioned below that are popular for Pacemaker Implantation Surgery as well:
|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 extra expenses in Thailand per person are about USD 50 per person.
Pacemaker Implantation Surgery in Thailand is offered in almost all metropolitan cities, including the following:
There are several doctors who are available for telemedicine consultation for patients requiring Pacemaker Implantation Surgery in Thailand. The following are some of the best doctors for Pacemaker Implantation Surgery in Thailand who are available for video consultation:
|Doctor||Cost||Schedule Your Appointment|
|Dr. Vichai Benjacholamas||USD 81||Schedule Now|
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 5 hospitals that offer Pacemaker Implantation Surgery in Thailand. The above listed hospitals 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.
The strength of Thai healthcare organisations is that they are wealthy in terms of human resources, financial resources and technological resources. It is an amalgamation of Thai public and private healthcare systems Thai HA Accreditation is presented by The Institute of Hospital Quality Improvement and Accreditation (HQIA) in Thailand which promotes standard and quality of healthcare in Thailand. This body also aims to bring a marked improvement in service delivery in Thai public and private hospitals.
The clinical care and hospitality in Thailand hospitals is of very high standards. Multispecialty hospitals translates into the option of having several medical and surgical specialties under one roof which gives a lot of choice to medical travelers. The specialst doctors in these hospitals are committed to providing you with the best of treatments available. Some of these multispecialty hospital groups are:
Thailand has long been synonymous as being a popular health tourism destination. One of the advantages that Thailand hospitals have is the International patient services in most of the top hospitals. All facilities such as embassy and airport transfer assistance, international insurance coordination, interpreters and medical coordinators and concierge services can be found at one place in Thai hospitals. Thai healthcare systems are known to give the entire specturm of treatment options, be it aesthetic procedures or tertiary care processes.
It is no wonder that people from all around the world seek out doctors from Thailand. Thai doctors are experienced and skilled in what they do. Two buzzwords are innovation and quality care that mean Thailand doctors excel. The experience of Thai doctors with innumerable international patients have refined their craft.
Once you have decided that you wish to come to Thailand for medical purposes, documents come into the picture. The documents are of different kinds such as travel related, treatment related and finances. The required documents are outlined here:
Thailand is an attractive medical tourism destination. Numerous tourist attractions, best medical treatment at economical prices make Thailand a complete package. We bring to you the most popular procedures available in Thailand that encapsulate the healthcare systems:
Immunisations and vaccinations are an essential part of any international travel. Even medical travellers coming to Thailand must get protected from potential health hazards. All such vaccinations recommended by CDC and WHO are mentioned here for your convenience. Yellow Fever, Japanese Encephalitis, Measles, Mumps and Rubella (MMR), TDAP (Tetanus, Diphtheria and Pertussis), Chickenpox, Shingles, Pneumonia, Influenza, Rabies, Meningitis, Polio, Hepatitis A, Hepatitis B, Typhoid and Cholera.
The hospitals in Thailand are equipped with the latest technologies and these are applied with precision to treat patients. There is a center for international patients in the hospitals in Thailand which caters to all the travel, transfer and accomodation needs of patients and their co travellers. Emergency services and integrated medical suppport services are available at Thailand hospitals. Radiology services, operating theaters, Intensive care units, cardiac care units, diagnostic laboratory and pharmacies are the different kinds of facilities being provided by Thailand hospitals.
Thailand is a major medical tourism destination in Thailand owing to the amalgamation of its tourism potential and the high standards of medical facilities offered by its hospitals. The affordable costs of various treatments means you can combine your holiday with getting treatment done at prices much lower than just the treatment costs in many countries. Healthcare facilities in addition to a strong cultural identity , natural beauty and rich history ensure Thailand has a strong medical tourism potential. We can safely say that Phuket and Bangkok are the most attractive medical tourism destinations in Thailand.
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