published Tuesday, April 7th, 2009

Donohue: Pacemaker insertion not tough for patient

DEAR DR. DONOHUE: My wife is 85 and is scheduled to have a pacemaker put in. She has been quite tight-lipped about this whole deal. I wasn’t aware that she had heart trouble. Is a woman of her age up to having open-heart surgery? What can you tell me about the procedure? What does a pacemaker do? I’ve been told she won’t be able to use a microwave oven or a cell phone after the operation. Why? — M.O.

A: Your wife isn’t going to have open-heart surgery. Installing a pacemaker isn’t as complicated as you might imagine and it isn’t draining for the patient. A pacemaker consists of a generator — a battery-powered unit about the size of a thin stopwatch. It’s put under the skin beneath the collarbone. One or two long wires emerge from the generator. The doctor passes those wires into a large vein that leads to the heart. That’s the end of the procedure. Very little cutting takes place, and the installation is over in a short time.

Every heartbeat starts out as an electric signal generated by the heart’s own built-in pacemaker, a small island of special cells in the upper part of the heart. That signal passes down to the lower heart chambers — the ventricles — through cables called bundles. When it reaches the ventricles, they contract and pump blood. If the natural pacemaker fails or the bundles are short-circuited, then the heart beats so slowly that blood fails to reach the brain. People feel dizzy and are on the verge of fainting. Under these circumstances, an artificial pacemaker is lifesaving.

Pacemakers also are useful for some people with severe congestive heart failure. Congestive heart failure makes people short of breath. Their ankles and feet often swell. Medicines help. When they don’t, a pacemaker can get the two ventricles to beat in sync so that they can pump more forcefully and relieve the congestion.

Pacemakers don’t stop people from using microwave ovens or cell phones.

c. North America Syndicate

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