When a patient needs to be hospitalized to install a pacemaker, the doctor will introduce a variety of pacemakers for patients and their families to choose from, and the prices vary greatly. Patients and their families are often at a loss, not knowing which one to choose. So, what kind of patient needs a pacemaker? What are the differences between various cardiac pacemakers?
When do I need to install a pacemaker
The most basic function of a pacemaker is to send out pulses regularly to stimulate the contraction of the heart muscle. Pacemakers are generally buried under the skin of the patient’s chest wall, and electrical pulses are transmitted to the heart muscle through connected wires to stimulate contraction of the heart muscle.
The heart is mainly composed of muscle (myocardium), and its function is to transport blood through the blood vessels to various organs in the body through rhythmic contraction. Generally, the heart of an adult contracts about 100,000 times a day. The heart has a special set of myocardial tissue that can generate and conduct electrical impulses, which is called the cardiac conduction system in medicine. If the frequency of electrical pulses is too low or the conduction is impaired due to myocardial inflammation, ischemia or aging, the heartbeat will slow down, the blood pump will be reduced, the blood supply and oxygen supply of the whole body will be insufficient, and the patient will experience dizziness and fatigue If the pause interval between two heartbeats is too long and the blood circulation is stagnated for too long, the patient will suddenly turn black and lose consciousness due to insufficient blood supply to the brain. After two or three seconds, he will quickly wake up again, clinically. Black and fainting.
When the patient’s cardiac conduction system has qualitative lesions and the above symptoms appear, it is necessary to be hospitalized to install a pacemaker.
Types of pacemakers
Single chamber and dual chamber pacemaker
pacemaker classified as basic single chamber pacemakers and dual-chamber pacemakers.
The single-chamber pacemaker is the simplest type of pacemaker. It has only one wire, one end is connected to the pacemaker, and the other end is fixed to the right ventricle to ensure that the heartbeat reaches the basic frequency.
The dual-chamber pacemaker has two wires, one end is connected to the two electrical pulse output ports on the pacemaker, and the other end is fixed to the right atrium and right ventricle respectively. Each time an electrical pulse is transmitted to the right atrium via atrial electrodes to stimulate atrial contraction; after an interval of 0.12 to 0.20 seconds, an electrical pulse is transmitted to the right ventricle via the ventricular electrodes to stimulate ventricular contraction. The dual-chamber pacemaker simulates the normal contraction sequence of the heart and is called physiological pacing. Those with conditions can choose a dual-chamber pacemaker, but its price is more expensive than a single-chamber pacemaker, and the operation is relatively more complicated.
Anti-nuclear magnetic resonance pacemaker
ordinary pacemaker common alloy materials, in a strong electromagnetic field may have a fever, but also by magnetic interference can not work properly. Therefore, patients with ordinary pacemakers are not allowed to undergo MRI examinations.
The anti-NMR pacemaker uses titanium alloy as the material of the pacemaker, which can resist the influence of the electromagnetic field on the pacemaker (currently the highest resistance strength is 3.0 Tesla), and the patient can undergo routine MRI examination. Of course, its price is much more expensive than ordinary pacemakers.
Pacemaker therapy class
last three decades there have been some special type of pacemaker to meet the clinical therapeutic purposes. There are two types commonly used clinically:
one type is implanted cardiac defibrillator (ICD), which has the functions of automatically identifying ventricular tachycardia, ventricular fibrillation, and automatic discharge defibrillation, and is mainly used for patients with high risk of ventricular tachycardia and ventricular fibrillation , Can significantly reduce the risk of sudden death.
Another type, commonly known as “three-chamber pacemaker”, has one more electrical pulse output port and lead than dual-chamber pacemakers to stimulate the contraction of the left ventricle, causing the left and right ventricles to contract at the same time, enhancing the combined contraction force of the left and right ventricles to pump out More blood. It is mainly used to treat patients with heart failure whose left and right ventricular contractions are not synchronized to improve the patient’s cardiac systolic function.
In the past two years, a new type of pacemaker, a leadless pacemaker, has appeared. The doctor sends an electric pulse generator to the heart through the patient’s femoral vein and directly fixes it in the right ventricle to stimulate myocardial contraction. Because it needs to be placed directly in the heart, there are high requirements on the size, weight, and tissue compatibility of the pacemaker, and the working life of the battery should be as long as possible. The current leadless pacemaker is only the size of a cigarette butt, the battery can work for 15 years, and has anti-magnetic resonance function, but the price is relatively expensive, and currently there is only a single-chamber pacemaker in China.
The types of pacemakers are roughly divided into the above categories, and doctors will recommend the appropriate type of pacemaker according to the condition of each patient according to the purpose of treatment. The price of similar pacemakers varies with different manufacturers, models, and additional functions. Experienced doctors will recommend pacemakers with appropriate cost performance to patients. Pacemakers are not as expensive as possible. The most suitable is the best.