Pacemaker Implantation in Thailand

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.

Pacemaker implant in Thailand

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.

Cost Comparison

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.

Treatment and Cost

7

Total Days
In Country

2 No. Travelers

3 Day in Hospital

4 Days Outside Hospital

Treatment cost starts from

USD 14500

Hospitals

About the Pacemaker Implantation Surgery

How does a Pacemaker Implant work?

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.

Heart Block

In this case, the impulse is either delayed or absent.

Cardiac arrest

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.

Symptoms

Some of the symptoms observed in patients requiring pacemaker implantation are:

  • Bradycardia
  • Tachycardia
  • Uncontrollable fatigue
  • Dizziness experienced throughout the day
  • Shortness of breath
  • Acute chest pain
  • Palpitation and fluttering of the heart (arrhythmia)

What is a pacemaker implant?

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.

How is Pacemaker Implantation Surgery performed?

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.

Recovery from Pacemaker Implantation Surgery

Recovery post a successful Pacemaker Implantation

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.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Thailand / Why should opt for Thailand as a destination for your medical treatment
Hospitals in Thailand have seen an increase in number in the past few years. One of the many reasons for such surprise growth in the healthcare division can be the development of the public health sector which comprises 9,765 health locations along with 1,002 hospitals. As the Public Hospitals in Thailand are operated by the MOPH (Ministry of Public Health), the Private Hospitals in Thailand are regulated under the Medical Registration Division. The treatments in Thailand are also keeping up with that of other major countries all across the globe. As of 2002, the Thai Government has provided a countrywide general healthcare system that covers 99.5% of the Thai population and ensures high-quality treatments in Thailand and affordable primary medical amenities to each and every citizen of Thailand. In the year 2009, the total national expenditure on healthcare was 4.3% of the GDP of Thailand. Due to such medical advancements in Thailand, the country has become the most preferred medical destination in the world providing wide-ranging medical treatments at highly-reasonable rates at good hospitals in Thailand.
What are the conditions of the hospitals in Thailand? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety. Here are a few JCI certified hospitals in Thailand :
  • Yanhee Hospital
  • Bumrungrad Hospital
  • Bangkok Hospital
  • Chaophya Hospital
  • BNH Hospital
  • Ramkhamhaeng Hospital
  • Vejthani Hospital
  • Bangkok Hospital Phuket
  • Samitivej Sukhumvit Hospital
  • Praram 9 Hospital
  • Chiangmai Ram Hospital
  • Sikarin Hospital
  • Synphaet Hospital
  • Bangkok Hospital Samui
  • Nonthavej Hospital
  • Bangkok Hospital Pattaya
  • Samitivej Srinakarin Hospital
  • Samitivej Sriracha Hospital
Are the doctors/surgeons in Thailand of the best quality?
Thailand is gaining recognition for the quality of its healthcare services after the US magazine CEOWORLD placed Thailand 6th in its 2019 list of countries with the best healthcare systems. Thai doctors gain a lot of skills during their course and this helps them practice effectively. Many doctors and surgeons also visit other countries for training and certification courses to enhance their skills and knowledge. Most doctors are exposed to a public and private healthcare system in order to be able to work in any condition. It is a collective effort from all the professionals to maintain the standard of health and Thailand is doing just that.
What is the process for obtaining a medical visa in Thailand?
Currently, medical tourists To Thailand are allowed in from 34 countries. All visitors must have proof of travel health insurance that covers a minimum of US$100,000 of medical costs incurred in Thailand, including medical costs in the event that they contract COVID-19. Under the CCSA regulations, medical tourists have to arrive by air to ensure effective disease control, not via land border checkpoints. All must have an appointment letter from a doctor in Thailand and entry certificates issued by Thai embassies across the globe. People wanting to visit Thailand for medical procedures need to contact the Thai Embassy in their country to organize the visa and paperwork. Thailand’s major hospitals will provide potential candidates with an appointment letter. Permission for medical tourists to be accompanied by up to three attending persons is intended to allow such patients to have spouses, parents, or assistants in attendance during their treatment in Thailand. However, such persons will have to conform to all the same entry requirements as the medical tourists themselves, including visas and health status.
What support services does MediGence provide in Thailand?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
  • Hospital Recommendation
    We recommend a hospital or a healthcare institution that is best suited for you, based on your ailment and its criticality.
  • 360-degree Hospital Review
    We give you a transparent and holistic view of the hospital and its infrastructure, accreditation, facilities, and expertise to give you confidence.
  • Doctor Validation and Communication
    We share a comprehensive profile of the treating doctor and also arrange a call to clear queries regarding treatment if needed.
  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
    We give a clear and accurate indication of the total cost of treatment including treatment, stay, meals, and other expenses.
  • Visa Assistance
    We provide and help prepare documentation for visa approval and coordinate with the embassy to expedite the visa process.
  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Thailand for medical treatment?
Bangkok is the capital of Thailand and the most sought - after destination for healthcare. It has more than 10 of the major hospitals in Thailand. The cost of treatment in Thailand is reasonable here. People tend to spend their recovery time in Bangkok as well as it is a beautiful city to visit as a tourist.

Our team of healthcare experts would be happy to assist you

Get In Touch
or call

(+1) 424 283 4838