Managing a pacemaker under quarantine

Health

Managing a pacemaker under quarantine

Sunday, May 10, 2020

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MORE than one million people globally use pacemakers or some other implantable cardiac device to manage certain medical conditions, such as a blockage in the heart's electrical pathways or an arrhythmia, congenital heart disease, or heart failure.

These conditions commonly result in symptoms such as extreme shortness of breath, constant and excessive fatigue, dizziness or light-headedness, and fainting, which can have a debilitating effect on daily life.

Heart disease is the leading cause of death worldwide. Ischemic heart disease accounted for 9.43 million deaths in 2016, according to the World Health Organization.

While the majority of the world's cardiovascular disease cases are attributed to developed countries, heart disease has become increasingly prevalent among middle- and low-income countries like those in the Caribbean.

Pacemakers are essential life-saving implantable devices that use electrical pulses to regulate the heart. A small titanium device, weighing less than an ounce, is inserted under the skin, and one or more wires are connected to the heart that sends tiny electric charges to the organ. The lithium-ion battery lasts from five to 12 years, as the pacemaker works only when needed. It detects and responds when the heartbeat is too slow, too fast, or irregular.

Although this tiny device is built to last, it requires consistent, periodic assessment to determine its efficacy.

Some common causes for pacemaker failure include:

● battery depletion;

● loose or broken wire between the pacemaker and the heart;

● electronic circuit failure, resulting from a break in wire insulation or a fracture in the wire;

● electrolyte abnormality (such as high potassium in the blood);

● electromagnetic interference from certain devices such as power generators, arc welders, and powerful magnets (found in medical devices, heavy equipment, and motors);

● a pacemaker lead gets pulled out of position; or

● a change in your condition that needs pacemaker reprogramming.

In the current COVID-19 climate of social distancing, with many places and people under mandatory or self-imposed quarantine, keeping a pacemaker assessment appointment may not only be difficult but may cause feelings of anxiety. Nonetheless, pacemaker assessment sessions are essential for the maintenance of the device to avoid problems with the battery, a lead, or an electrode.

By using a specialised diagnostic device a cardiologist is able to analyse the battery function, how well the leads are conducting electricity to the heart, and detect any signs of malfunction long before detected by the patient.

New technology and remote monitoring allows the device to transmit information over the Internet. This has impacted the quality of life of users by reducing the need for travel and spending long hours at a doctor's office. With the use of remote monitoring cardiologists are able to monitor your device activity and communicate with the patient about the performance the device. Remote monitoring, however, is not for all devices. Get in touch with your cardiologist to see if this programme is compatible with your device.

Partners Interventional Centre of Jamaica Limited is a comprehensive cardiac centre located on the second floor of the Medical Associates Hospital, 18 Tangerine Place, Kingston, Jamaica.


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