Pacemaker (cont.)
Can some pacemakers automatically adjust the heart rate?
Pacemakers can be equipped with a rate of activity response
feature. This feature allows the pacemaker to pace faster during
periods of physical exertion or stress. The body's metabolic
activity increases with exercise and stress. Heightened metabolic
activity in turn increases the need for more blood supply to muscles
and other organs. Newer pacemakers with rate of activity response
features can measure the body's metabolic activity (with sensors) and
increase heartbeats by accelerating the pacing rate during exercise
and stress. After exercise or stress, the pacing rate returns to the
previously programmed setting.
Different rate of activity response pacemakers use various sensors
to measure metabolic activity. One type of pacemaker contains a
sensor that detects vibration related to activity. The pacing rate
accelerates when the pacemaker senses increased vibration. Another
type of pacemaker has a sensor that detects the rate of breathing.
The pacing rate increases when a person breathes faster. Other types
of pacemakers contain sensors that measure changes in body acidity,
pressures inside the heart chambers, and body temperature, etc. Each
of these sensors has its strengths and weaknesses. Because no one
sensor method is perfect, some pacemakers now incorporate multiple
sensors to more accurately gauge the body's metabolic activity.
Living with a pacemaker
Most patients can eventually return to normal activities after
receiving a pacemaker. In fact, patients with a pacemaker usually
feel better and may be able to do more than before.
It is normal to have some pain in the area around the implanted
pacemaker for a week or so after the procedure. Patients are given
pain medications to alleviate this post-surgical pain. It is also
normal to feel some numbness and heaviness around the pacemaker for
some months.
Patients can return to most of their normal daily activities a few
days after the procedure. During the first weeks after the procedure,
the patient is asked not to lift the arm on the side of the pacemaker
implantation over the head. This precaution is to avoid dislodging
the lead(s) and to allow the lead(s) to become firmly secured inside
the heart. The patient is also asked to avoid heavy lifting, contact
sports, and other vigorous exercises for a few weeks.
The sutures at the incision site are removed between one to two
weeks after the procedure, usually in the doctor's office or in a
pacemaker clinic. This is also the time to discuss with the doctor
issues regarding activity levels, exercises, symptoms, when and how
frequently to check the function and the battery levels of the
pacemakers, signs of pacemaker malfunction, and precautions regarding
interference from electrical appliances and devices.
Most doctors allow their patients to return to work in one to two
weeks, even though the incision may take several weeks to heal
completely. Some doctors recommend that their patients subscribe to
telephone monitoring services. The pacemaker signals which are
transmitted to the doctor' office or the pacemaker clinic by
telephone can be analyzed to make sure the pacemaker is functioning
properly.
Every patient is given a pacemaker ID card to carry. The ID card
contains information regarding the pacemaker. The should be shown to
other doctors and dentists. Occasionally, security officers at the
airport will request seeing the card.
Next: When to report problems to the doctor »
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