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Introduction
The brochure, which you hold in your hands, is designed for you - the distinguished winner of the pacemaker (ECS), your loved ones that you find in these pages the answers to all the questions you may have. We will tell you that such a pacemaker and how it works and get acquainted with the peculiarities of the structure of the heart, and try to explain why you need a ECS. Also, you will learn a little about the operations of ECS implantation, about the recovery period and the peculiarities of life with a stimulant.
But most importantly, what we want to tell you now is that currently there are more than one million people who live with stimulant and thanks to him, returned to normal and fulfilling life - to work, school, home business, travel.
We understand your concerns before the upcoming surgery and will try our best to make this event has become less exciting for you and the unknown.
We do not set ourselves the task to give you any medical advice or recommendations. All matters relating to your health and working ECS, you should ask your doctor.
Development of pacing in recent decades has led to the solution of many problems associated with cardiac arrhythmias. And now the surgery to implant ECS has become everyday, and the reliability and quality of modern devices, made on the basis of the latest achievements of technical thought, is confidence both doctors and patients.
You can trust your pacemaker. As the long-term experience, the majority of patients after surgery significantly improves the health and quality of life due to the fact that the electrical impulses generated by operating reliably stimulant, helps the heart in its work.
We are pleased to have the opportunity to help you, and hope that the device is made by our company, and this booklet is written especially for you, will help you find peace and health. I sincerely wish you happiness and long life!
History of creation pacemakers
For the first time an electric current pulses ability to cause muscle contraction saw the famous Italian Alessandro Volta (1876). Then the Russian physiologists and Yu.M.Chagovets N.E.Vvedensky studied the impact of particular electric pulse to the heart, and suggested the possibility of using them to treat certain heart diseases. In 1927, G. Hyman has created the world's first outdoor pacemaker and applied it to the clinic for the treatment of a patient suffering from a rare pulse and loss of consciousness. This combination is known as Morgagni-attack Edems-Stokes (MES).
In 1951, US surgeons Callaghan and Bigelow used a pacemaker to treat a patient after surgery, because she developed complete heart block with cross-rhythms and rare bouts of MES. However, this unit had a big disadvantage - it was out of the patient's body and to the heart pulses carried by wire through the skin.
In 1959, Swedish scientists have developed implantable, ie wholly under the skin, a pacemaker (Siemens-Elema). Of course, the first stimulants were short-lived: from 12 to 24 months. However, it was a huge step forward.
In Russian history pacing counts since 1960, when Academician A.N.Bakulev appealed to the country's leading designers with a proposal for the development of medical devices. And then in the design office of precision engineering - one of the leading enterprises of the defense industry, led by A.E.Nudelmanom - first began developing implantable ECS (A.A.Rihter, V.E.Belgov). In December 1961, the first Russian stimulant, EX-2, was implanted academician AN Bakuleva patient with complete atrioventricular block. EX-2 was armed with doctors for over 15 years, saved the lives of thousands of patients and has established itself as one of the most reliable and miniature stimulants that period in the world.
More than thirty-five years term KBtochmash division, headed by V.E. Belgovym was created more than 30 models of implantable pacemakers.
A special place among the established instruments takes EX-445, designed for operation cardiomyoplasty first proposed and mastered in Russia, conducted in patients with severe heart failure with contraindications to heart transplantation. EX-445 was awarded a diploma and a gold medal at the International Exhibition in Brussels.
Your pacemaker is made Group of Companies « ELESTIM-CARDIO», created on the basis of scientific, technical and intellectual potential KBtochmash. Taking the baton from KBtochmash for further development of Russian pacing, a group of companies "ELESTIM-CARDIO" currently holds a leading position in the Russian market for the development and serial production of pacemakers and electrodes to them. We recognize that the quality and reliability of our products - the key to the quality of life of tens of thousands of patients. Therefore, special attention is paid to careful quality control phase in the production process and conducting technical and medical tests by independent organizations. Our partners are more than 100 clinics in all regions of Russia and CIS countries.
Keeping the best traditions and modern technologies of the defense industry in close cooperation with doctors, we are implementing their own scientific advances in the latest developments of our products.
How does your heart
Heart - a unique muscular organ located in the middle of the chest. The heart pumps blood throughout the body, saturating the cells with oxygen and nutrients.
The muscular septum divides the heart longitudinally into left and right halves. Valves dividing each half into two chambers: an upper (atrial) and lower (ventricle).
Reducing, heart muscle pushes blood first through the atria and then the ventricles through. In the lungs the blood is saturated with oxygen and fed through the pulmonary veins to the left atrium, then into the left ventricle and out through the aorta and branching from it spreads arterial vessels throughout the body.
Giving oxygen, the blood is collected in the vena cava, and through them - in the right atrium and right ventricle. From there the blood through the pulmonary artery into the lungs, which is enriched with oxygen again. The main indicator of cardiac performance is the amount of blood that it should pump for 1 min. Typically for an adult is not less than 5.0 liter (300 liters per hour of 7200 liters per day). Heart beats over 100,000 times per day, driving blood through 20,000 km of veins and arteries, circulatory system components.
When an adult is at rest, the heart does from 60 to 80 beats per minute. When exertion, stress, or when the driving frequency may increase heart rate to 200 beats per minute.
Cardiac conduction system
Perform your heart functions in the collection and pumping of the blood depends on the rate of motion of tiny impulses coming from the upper chambers of the heart to the bottom. These pulses are distributed by the cardiac conduction system, which sets the desired frequency, regularity and timing contractions of the atria and ventricles in accordance with the needs of the organism.
An artificial pacemaker, called the sinus node or node-flick Keys, located at the top of the right atrium. It - anatomical education, which controls and regulates the heart rate, in accordance with the activity of the body, the time of day and many other factors that affect the human being.
The heart's natural pacemaker having electrical impulses, which pass through the atria, causing them to fall to the atrioventricular (t. e. atrioventricular) node, located on the border of the atria and ventricles. Then the excitement on the conducting tissues distributed in the ventricles, causing them to cut. Then the heart is resting until the next pulse, which begins a new cycle.
The correctness of the heart, its rhythm, you can check his hand on his heart or by measuring your pulse.
Why do you need a stimulant
Most often, doctors recommend the use of a pacemaker, when the various symptoms (dizziness, high blood pressure, headaches, pain in the heart) indicate a slow heart beat. This condition is called bradycardia.
Bradycardia is usually caused by a lesion of the sinus node (sick sinus syndrome) or diseases of the cardiac conduction system (heart block).
♦ sick sinus syndrome (sinus infection). In these cases, the pulse frequency in the sinus node is significantly reduced and does not meet the needs of the organism (Figure 2).
♦ Heart block. Thus not all of any pulses reach excitation sinus ventricular (AV block incomplete) or they do not pass the atria and ventricles and independently. Heart block can occur in the atrio-ventricular (atrioventricular) node or conductive tissue (Figure 3).
Cardiac arrhythmias can be caused by various causes, including hereditary defects of the heart, the process of aging, the formation of scar tissue changes after myocardial infarction, infectious diseases; and unknown causes.
Thus weakened heart function is not sufficient to pump the required amount of blood through the circulatory system. The first body reacts to the lack of blood, it is a very sensitive brain. Due to insufficient oxygen supply you may feel dizziness, weakness, fatigue, sluggishness, sudden respiratory failure and even loss of consciousness.
In these cases, use an artificial pacemaker - pacemaker capable of stimulating the heart electrical pulses. This device sets the heart a constant and adequate rhythm, causing the heart muscle to contract rhythmically. Thus, the normal blood circulation and the supply of oxygen and nutrients to the body.
How does your stimulator
With the help of an implantable pacemaker restored the supply of regular electrical impulses to the heart muscle. All pacemaker system consists of two parts:
♦ Pulse generator, which is actually called the ECS. Pulse generator includes electronic circuitry and a battery which are placed in a sealed enclosure. Electronic circuit conducts research activity of your heart and generates impulses sent to the heart by controlling their timing.
♦ The electrode (or electrodes of two) that is a special spiral conductor having sufficient flexibility to withstand the torsion and bending caused by movements of the body and heart contractions. The electrode sends the heart an electrical pulse produced by the pulse generator, and is back information about the activity of the heart.
Electrode contact with heart through a metal head at the end of the wire. With the help of her stimulator "follows" the heart's electrical activity and sends electrical pulses (stimulates) only when they are needed heart. In that case, if cardiac activity is completely absent or very sparse rhythm, a stimulant becomes permanent pacing mode and sends impulses to the heart at a given frequency. If you will be shown the spontaneous activity of the heart, the stimulator goes into standby mode, t. E. Will function "on demand" mode (on demand).
Rhythm will drop when the battery starts to run low. The pacemaker must be replaced when its rate decreases to a certain value (reduced frequency is indicated in the passport stimulator). In this case you need to undergo outpatient examination schedule established by your doctor.
Types of pacemakers
Type the necessary stimulant to you depends on your individual circumstances. Your doctor will prescribe the most suitable for your health pacemaker.
In most cases, heart rhythm disorders of the time, the heart continues to contract normally. Therefore stimulator activated only when it is required. It is automatically activated and stimulates the heart, until it begins to beat in a normal rhythm. What kind of devices are called "on demand pacemakers", since they act only when necessary.
Pacemakers can be "programmed". If your health condition and the need to stimulate change, your doctor may change the setting of certain parameters of the stimulator. This adjustment is performed on an outpatient basis at the time of receiving the next doctor without additional surgery.
Single-chamber pacemakers
The single chamber pacemaker a single electrode is used that is placed in either the right atrium or the right ventricle (depending on the diagnosis) to detect its own capabilities and its heart stimulation.
Dual-chamber pacemakers
For a dual chamber pacemaker usually requires two electrodes, one of which is located in the atrium, and the other - in the ventricle. Dual-chamber pacemaker detects the heart atrium and ventricle activity, identifying the need for stimulation. In the process of coherent ("sequential") for the reduction of atrial stimulation is immediately followed by contraction of the ventricles, which makes the heart beat closest to the natural, more physiological.
The operation of the pacemaker implantation
You will certainly be interested to know a little bit about the upcoming operation.
To date, pacemaker implantation surgery is the usual procedure. The operation is performed in a specialized hospital cardiac surgery and usually takes one to two hours.
Usually stimulators implanted with electrodes which are driven to the heart through a vein (transvenous). Stimulator is placed in the upper part of the chest in the subclavian region, forming a bed under the muscle for it. The skin incision is made approximately 5 cm in length, parallel to the clavicle. With the help of a special catheter and a needle electrode is inserted through the puncture into the large subclavian vein and is held under the control of X-ray installations in the heart cavity of the right ventricle (or atrium). Using a special device, situated at the end of the electrode, it is fixed (attached) to the heart wall. The skin is sutured cosmetic seams. Almost on the second day after the operation the patient in the event that the operation, and the initial programming were no complications, can be discharged home under medical supervision in the community.
There are other methods of pacemaker implantation. Undoubtedly, the doctor will recommend you the most suitable way in relation to your individual characteristics.
The illustrations below show the different types of pacemakers implanted transvenous method.
The figure shows the types of pacemakers implanted transvenous method: a) ventricular pacing; b) atrial pacing; c) dual-chamber pacemaker with two electrodes; d) dual-chamber pacemaker with one electrode.
The recovery period
Some time after the operation you will obviously realize that you implanted pacemaker. This is a normal feeling and usually with time it passes.
In the beginning you may experience discomfort in the incision area. But in the event of signs of inflammation (redness, pain, fever) should immediately see a doctor at the place of operation.
Sometimes there is a "twitch" on location spot stimulator. It is perfectly safe and is caused by minuscule electrical current produced by the pacemaker, which can excite the surrounding tissue. After a while, these effects usually disappear spontaneously or eliminated by reprogramming the pacemaker.
Such complications occur in a significant percentage of patients. The vast majority of owners do not have a pacemaker absolutely no problems with their devices.
Soon you begin to forget that wearing a artificial pacemaker. Symptoms suggestive of cardiac arrhythmias, will shrink and soon disappear altogether.
Gradually, as the improvement of health and follow your doctor's advice, you can go back to business as usual:
♦ work, study;
♦ travel in transport, driving a car;
♦ taking a bath or shower, swimming;
♦ sex life;
♦ various kinds of recreation - walking, hiking, working in the garden or in the garden, outdoor games.
Pacemaker - new quality of life. Young women suffer during pregnancy and childbirth, as well as their other peers.
However, it is very important in this case to follow the advice of your doctor. Return to normal activities should lead to an improvement, and not a deterioration of your health.
Your life with a pacemaker
Obviously, now you are expecting to read how your pacemaker will affect your life.
You should know that the former allows you to avoid the condition that threatens your life, and therefore feel confident and try to live the way you've always lived. Most patients after pacemaker implantation returned to an active productive life, although many of them for more than 65 years. It is known that the famous hockey player Bobby Hull US team after their pacemaker implantation in 50 years played for the national team.
Live as people live to your age group. Wrong to think that to avoid various complications and prolong the operation of the pacemaker can be immersed in the hothouse conditions or severely limiting their activity. Your doctor will advise you what to do and what to avoid.
Pacemaker - a complex electronic device, which can influence the external electromagnetic fields. Consider the possible impact on the operation of your pacemaker.
The use of household appliances
The pacemaker has built-in protection against interference from other electrical devices. However, if you assume that an electrical device causes interference with your pacemaker (feel dizziness, heart palpitations), just move away from the device, or turn it off. Your pacemaker will not have any permanent changes, and it will resume normal operation. However, in this case it is advisable to consult a doctor in order to check the parameters of pacemaker settings.
Most electrical devices of everyday use are absolutely safe and will not affect the operation of your pacemaker.
You can use an ordinary household appliances, provided that it is in good condition (in order to avoid electrical interference):
♦ microwaves;
♦ TVs, radios, tape recorders; computers;
♦ hair dryers, shavers, curling irons;
♦ washing machines, electric ovens, vacuum cleaners;
♦ toasters, mixers.
To reduce the possibility of interference, hand appliances is recommended to keep a minimum distance of 10 cm from the pacemaker location.
Away from the pacemaker is recommended to keep the soldering irons, demagnetizing devices, devices with motors (electric drill, hair dryers, electric shavers) and generators of radio waves (cellular phones, transceivers, bilateral).
Do not keep the magnet or magnetized materials close to a pacemaker.
Cell Phones
Recent studies have shown the possibility of interaction between mobile phones and pacemakers. However, any interaction effects are temporary and disappear when the phone is incredibly distant.
It is recommended to have a cell phone at least 30 cm away from the pacemaker and keep it at the ear on the opposite side, which is implanted device. On itself carry a cell phone is not recommended.
Using the office and industrial equipment
Office equipment and working equipment do not affect the operation of your pacemaker if it conforms to the electrical safety requirements. Remember that the equipment you used and the equipment should be in good condition and fit properly grounded.
Examples of such equipment and technology can be:
♦ computers;
♦ Copying and duplicating machines;
♦ electronic means;
♦ carpentry power tools (electric plane, electric, etc.);
♦ Metal Processing Machinery and equipment locksmith.
It is not recommended to work on the electrical system, you can not turn off the extra.
Before working with industrial equipment of high voltage and powerful magnets, as well as near transmitting towers and antennas, you should consult a doctor.
Exposure should be avoided by powerful sources of electrical noise, such as:
♦ saws;
♦ welding equipment;
♦ dielectric heaters;
♦ electric steelmaking furnace
Care should be taken while near the coil, distributor or spark plug wires running car engine. Any adjustment of the distributor must be done with the engine off.
Not recommended for a long time to be near the high-voltage lines, high-power electric microwave (MW) units and transmitters. Crossing the high-voltage power line should, if possible, near the poles.
Devices pre-control of passengers at airports and theft detection system.
It is not recommended to go through pre-control devices at airports (show your "patient card with an implanted pacemaker"). If necessary, replace the personal examination procedure.
Medical procedures
It is necessary to tell any health care professional that you have a pacemaker, while presenting his card-identity. However, most medical procedures are safe for your ECS:
- diagnostic X-rays, including chest X-ray, dental images, mammography;
- dentistry, including drilling and sonication;
- Electrophoresis if the equipment is not targeted to the location of the implanted device.
Absolutely contraindicated
- ultrasonic radiation (UVR);
- diathermy;
- D'Arsonval currents;
- Lithotripsy;
- transcutaneous nerve stimulation
- magnetic resonance diagnostics;
- hyperbaric oxygen therapy
After applying external defibrillators (if necessary) should check the value of pacing stimulation parameters. When receiving physiotherapy it is recommended to check your pulse.
Before you agree to any medical procedure or surgery, consult your doctor
IT HAS APPROPRIATE TO PAY PARTICULAR ATTENTION
The fastest way to check if your stimulator is a count your pulse is OK. The pulse rate should be the same as or higher than the programmed frequency pacemaker clinic. At discharge from the hospital you will be shown how to measure heart rate, and appoint the first day of the regular inspection.
You should periodically measure the pulse for a minute while sitting or lying down. Your doctor may advise you to keep a diary where you record heart rate, date and time of counting. If necessary, you can help your family members.
Regular screening will help your doctor to check the operation of the pacemaker, its functions, battery status. Schedule survey will be your doctor. It will depend on the type of your pacemaker, the state of your health, as well as the practices adopted by your doctor.
Regular checks the pacemaker in the doctor's office includes a registration of an electrocardiogram (ECG). After verification may require reprogramming the pacemaker to your Stimulation therapy better suit your condition. The doctor will do this by using external programming device, so that no operation for it is not required. Changing the stimulation parameters, you can also enter in a diary with the date and the new device parameters.
It is important to observe all the prescribed visits to the doctor and the clinic.
As we approach the expected life of the replacement pacemaker regular surveys are more frequent. Your doctor will be able to determine the approximate period of the pacemaker service depending on the type of pacemaker and its operation. Usually, the pacemaker is designed for 7-10 years of continuous operation. With the approaching end of the term stimulant to change the pacing rate, thus giving a signal to be replaced. Your doctor or nurse will recognize this change of frequency during regular inspections. But even when the unit pulse rate drops to a certain level, you need not worry. Your pacemaker will function normally for several months. During this time, the pacemaker will be replaced by a new device.
When replacing a device, your doctor checks the condition of the electrode (electrodes). With their satisfactory condition existing electrodes are in place and connected to the new pacemaker. Replacing the device is very simple and fast.
Necessary documents you
Inside the package you will find the pacemaker with the following documents:
♦ passport to the device.
♦ set the registration card "of the patient with an implanted Map (reimplantirovannym) antiarrhythmic device."
♦ patient with an implanted pacemaker card containing the map of monitoring a patient with a pacemaker implanted.
The passport to the device you will find settings and work functions EX, specifications, and warranty of the company.
The registration card filled with your doctor after pacemaker implantation. On each map indicated its purpose. Card designed for you, you can put in your diary.
We kindly ask you to send us the registration card intended for the manufacturer. It is very important to have information about you and your device. Also contact the company in case of change of your address, phone number, doctor's shift or change stimulation parameters (please provide new options ECS). Your help will allow us to better serve you and your doctor.
"Patient card with an implanted pacemaker" fills doctor after implantation. We recommend you always carry this card with them and produce when necessary.
IT IS IMPORTANT
♦ Watch for physical signs that may indicate a need to check the pacemaker, and immediately inform your doctor at the place of operation at occurrence of any of the following symptoms:
- Shortness of breath, dizziness and fainting.
- Swelling of the feet, ankles, hands and wrists.
- Inflammation (redness, pain, fever), swelling or fistula in the field of surgical sutures.
- Unusual changes in heart rate during sleep or at other inappropriate times.
♦ Strictly follow the schedule of regular surveys assigned by your physician.
♦ Follow all doctor's recommendations regarding medication, exercise, diet. Tell your doctor if you plan to change the level of stress, travel or change the address.
♦ To report any health care professional that you have a pacemaker, while presenting the card EX-license holder.
♦ If you have any questions relating to your heart health or the pacemaker, consult your physician.
♦ It is recommended to always carry a "patient card an implanted pacemaker."
Conclusion
Now you know why you need a stimulant, how it works and what you need to do in order to live a normal, full life.
The pacemaker determines the rhythm of the heart, ie. E. The rate at which it beats.
Of course, it can not remove the cause of your heart rhythm disorders, as well as to prevent the natural age-related changes that occur in the heart and the circulatory system of each person.
However, we hope that the device works reliably manufactured with the latest technology, will save you from many of the symptoms associated with cardiac arrhythmias, and prolong your life for many years.
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