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MEDICAL THERAPY: PACEMAKERS Q. When is a pacemaker needed ? A. A pacemaker is required in case of a complete heart block. As you have learnt Q. Are there any other precautions to be taken ? Permanent pacemakers are required in those cases where complete heart block has become permanent and the patient exhibits symptoms of inadequate blood circulation. The pulse and heart rate remain permanently below 40 per minute. There are other less common indications for permanent pacing, but they are beyond the scope of this book. Of all the cases of myocardial infarction, only a few need a permanent pacemaker. Q. What does a pacemaker consist of ? A. A pacemaker is a small, box-like structure containing electric circuitry to fire off impulses at regular intervals and a sensing device which informs the device when to deliver the artificial impulses. The electric power is supplied by a small battery contained inside the gadget. Q. How long does the battery last ? A. The modern lithium battery lasts for more than 5 years. Q. Are there many types of pacemakers ? A. The earlier pacemakers worked the ventricles continuously. Now, there are demand pacemakers, i.e., if the heart rate falls below the normal rate, they will automatically sense this and send out impulses as long as required. We have now pacemakers which activate not only the ventricles but also the atria, so that they produce a more normal haemodynamic effect. Q. How is the pacemaker implanted ? A. A thin wire along with the probe of the pacemaker is introduced into a large vein in the neck through a small incision and pushed towards and into the heart. The pacemaker is then attached to the other end of the wire and is implanted under the skin of the chest or abdomen. It is made of such a lightweight material which does not react with body tissues. *37\328\8* Cardio & Blood |
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