Cardiology: Sick-Sinus-Syndrome (sss) — Pacemaker implantation. Treatment
Sick sinus syndrome most commonly affects the elderly. According to different authors, the disease prevalence rate among them reaches 1 to 2%. Failure of the sinus node to perform its functions normally results in slowing of the heart rate and development of different kinds of arrhythmias. Implantation of a pacemaker allows many patients to get back to normal life.
What Is It?
Pacemaker is a device generating the electronic pulses. After installation in the heart chamber, it takes over the functions of the failed sinus. The pulses start arriving to the heart muscle continuously at a preset rate. Some models (frequency-adaptive) are able to correct the heart rhythm based on the patient's physical activity.
The device installation is recommended for the following conditions:
- availability of pronounced SSS manifestations (dizziness, dyspnea, fatigue)
- bradycardia less than 40 beats per min.
- frequent pauses in the heart work,
- heart failure developed in the background of SSS.
The surgery is not performed:
- for asymptomatic forms of the disease,
- when SSS is caused by drugs,
- during the periods of acute infection or acute exacerbation of chronic pathologies
- when the patient suffers from the other serious cardiopathies.
The procedure is performed under local anesthesia. The surgeon pierces a vein under the collarbone and inserts a plastic tube with electrodes through it. Under the X-ray monitoring, the electrodes are brought to the heart and attached to its wall.
Both single-chamber (the electrodes are installed only in one atrium or ventricle) and two-chamber (the electrodes are installed simultaneously into the right ventricle and right atrium) pacemaker models are used for SSS. The physician determines which device is right for the patient during the surgery planning stage.
After electrode installation, they are connected to the main unit, which is sewn under the skin. All manipulations take 1.5 to 2 hours.
Pain may be felt at the implant site for a few days. To reduce the same, the patient is recommended to take analgesics. Also, the antibiotics are prescribed as required.
Adapting to the device and return to the normal lifestyle takes 1 to 2 months. The patient must periodically visit the cardiac surgeon to evaluate the device operation.Hide
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