A pacemaker is a small medical device designed to regulate abnormal heart rhythms. Pacemakers produce a low-grade electrical current that stimulates the heart to beat. They have a number of clinical indications including tachycardia, cardiomyopathy, atrial fibrillation and brachycardia. Although all surgery presents some risks to the patient, the chance of having any problems after pacemaker surgery is very low, according to the National Heart Lung and Blood Institute.
Collapsed Lung
A collapsed lung, also known as a pneumothorax, may occur during or after pacemaker surgery. If the lungs are nicked during surgery, air can escape into the chest cavity and the lung partly collapses. According to the British Lung Foundation, there are varying degrees of pneumothorax. If a patients is only mildly breathless, he will likely be sent home with no further treatment necessary. If a bigger lung collapse occurs, the doctor may decide to with suck the air out of the chest cavity. This is done using a narrow plastic tube under local anesthetic. The British Lung Foundation says that it this doesn't work, the doctor may employ a large tube attached to a bottle of water to allow air in the chest cavity to bubble out. If the lung still doesn't heal following treatment, surgery may be necessary.
Infection
According to a 2010 research paper published in "Circulation," patients undergoing pacemaker surgery may be at risk of developing a bacterial infection. The lead author, G.M. Viola, says, "Along with the rising use of cardiac implantable electronic devices (CIED) there has been a disproportional increase in the number of infections of such devices." The author adds that "nonstaphylococcal CIED-related infections are prevalent and diverse with a relatively low virulence and mortality rate" and recommends that patients undergoing implantation of CIED devices such as pacemakers should receive antibiotics "until microbiological data become available."
Hematoma
Patients undergoing pacemaker implantation surgery may be at risk of hematoma, according to research published in 2010 in "Circulation, Arrythmia and Electrophysiology." A hematoma occurs when blood collects on the outside of the blood vessels, which may lead to hemorrhage. The lead author of the research, I.B. Kutinsky, says, "Device implant pocket hematoma is a recognized complication after permanent pacemaker and implantable cardiac defibrillator implantation. Pocket hematoma is associated with local discomfort, an increased risk of infection and may require surgical intervention or lead to lengthier hospital stays." The author adds that the use of use of clopidogrel or intravenous heparin "significantly increased the risk of hematoma" and should therefore be avoided prior to surgery.
References
- Patient UK: Pacemakers and Pacing
- NHLBI: What Are the Risks of Pacemaker Surgery?
- British Lung Foundation: Pnemothorax
- Circulation: Nonstaphylococcal infections of cardiac implantable electronic devices.
- Circulation, Arrythmia and Electrophysiology: The Risk of Hematoma Complications after Device Implant in the Clopidogrel Era.
