Pacemaker Implantation Cost in Turkey

A healthy heart has its pacemaker that helps in the rate of regulation of the heartbeat. Sometimes people have conditions that can cause their heart to beat irregularly or abnormally. In these cases, a pacemaker device is recommended. A pacemaker is an electronic device, which sends an electric impulse to the heart muscles to maintain a suitable heart rate and rhythm. It has two parts a lead and a pulse generator.

Pacemaker Implantation in Turkey

Over the past years, the Turkish government has taken decisive steps in improving their healthcare facilities. Turkey now offers high-quality medical services, latest medical technology, board-certified staff and well-skilled surgeon. Pacemaker surgery in Turkey is performed by some of the most recognized cardiothoracic surgeons. Turkey has always been a known tourist destination and now with so much of advancement in its medical facilities; it has also become a popular medical tourist destination.

Cost comparison

 

Pacemaker implant cost in Turkey, quality of treatment offered are at par with some of the most popular medical tourism destinations like Germany, Singapore, Turkey, and Hungary. Pacemaker implant surgery including the travel, five -star accommodation and sight-seeing cost in Turkey comes to even less than one-sixth when compared with the treatment cost offered in US or UK.

Treatment and Cost

7

Total Days
In Country

2 No. Travelers

3 Day in Hospital

4 Days Outside Hospital

Treatment cost starts from

USD 9000

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 Turkey / Why should opt for Turkey as a destination for your medical treatment?
The healthcare infrastructure of Turkey comprises health centers, health posts, mother and child health and family planning centers, tuberculosis dispensaries, etc. Health centers are each staffed by a team consisting of a doctor, a nurse, a midwife, a health technician, and an administrator. Health posts report to health centers and are each staffed by a midwife. Health centers and health posts are the only settings providing preventive care, health promotion, and community-based health services. All other settings use specialists to provide just primary diagnostic and curative care. Turkey is turning out to be a preferred destination for medical treatment by many people across the world for its pace of development. The people are friendly and the administration is efficient. After the treatment in Turkey, one can even choose to unwind amidst its beauty.
What are the conditions of the hospitals in Turkey? 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 Turkey :
  • Anadolu Medical Center
  • Hisar Intercontinental Hospital
  • Medipol Mega University Hospital
  • NP Istanbul Brain Hospital
  • Neolife Oncology Center
  • Liv Hospital
  • Medicana Healthcare Group
  • Kadikoy Florence Nightingale Hospital
  • Istanbul Memorial Hospital
  • Memorial Antalya Hospital
  • Taksim Hospital
  • Dunyagoz Hospitals Group, Istanbul, Turkey
  • Medical Park Hospitals Group
  • Medical Park Göztepe Hospital Complex
  • Acibadem Maslak Hospital
  • German Hospital Taksim
  • Medical Park Bahçelievler Hospital
  • Göktürk Florence Nightingale Medical Center
  • International Hospital
  • Aydinlar Dental Group
Are the doctors/surgeons in Turkey of the best quality?
Doctors in Turkey are highly educated and well trained. This is one of the reasons why many people flock to Turkey for medical treatment. The doctors are skilled and can converse fluently in English and other foreign languages.
What is the process for obtaining a medical visa in Turkey?
At present, there are two types of medical visas available for your visit to Turkey:
  1. Medical Visa, which can be obtained from the Consulate of Turkey
  2. Online Visa (eVisa), which can be obtained in advance of arrival via the government of Turkey’s online visa system.
Visitors must obtain a medical visa for traveling to Turkey unless they come from visa-exempt countries and territories or citizens of those countries, which are eligible to apply for an e-Visa online. How To Acquire Online Medical Visas (e-Visa or electronic visa) :
  1. Simply visit www.evisa.gov.tr and apply on the platform by selecting your country and the type of passport or identity card. The platform is self-explanatory and will guide you throughout every step.
  2. Once you are done filling the form, save and download the form for future references.
  3. The applicant must visit the nearby Turkish embassy in his/her country to get the approval of the Consulate.
  4. Once the visa is approved, the travel dates can be scheduled accordingly.
What support services does MediGence provide in Turkey?
MediGence has been praised on a global scale for the list of services they provide. Apart from the listed services, the staff and the guides are adorned for their customer interaction, impromptu assistance, and various other assistance related guidance throughout the tour. Thus, the list of services provided by MediGence are:
  • Insurance query related guidance
  • In-detail guidance till completion of the medical tour
  • Visa Assistance
  • Free airport to hospital transfer
  • On-Ground Support
  • Teleconsultations
  • Accommodations Assistance
  • Rehabilitation and recovery services
Which are the best cities in Turkey for medical treatment?
The capital of Turkey is Istanbul. Istanbul is easily accessible and the preferred location for medical treatment. Other cities with good hospitals are Izmit and Bursa.

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