Dr Vanita Arora - Could your pacemaker be malfunctioning?

Mr Anant Singh, is a 65-years-old retired man who was enjoying his retired life after a pacemaker was implanted into his chest to stabilise the arrhythmia he was suffering from. But lately he had been feeling breathless for some time and needed three to four pillows to prop him up while he was sleeping to help him breathe. Mr Ananth would constantly feel low on energy and fatigued continuously. Although he thought his ailment was due to his age, the symptoms eventually got worse with time. One night after suffering from severe breathlessness Mr Ananth was rushed to the hospital, where it was found that one of the leads of his pacemaker had shifted position. Read more about arrythmia and why it is a cause for concern.

What is a pacemaker?
 A cardiac pacemaker is a group of cells within the heart that together induce contractions and control the pace of the heart. When the cardiac pacemaker does not function properly an artificial pacemaker is placed which sends electrical impulses to the heart muscle to provide proper heart rhythm. An artificial pacemaker may be used to treat repeated syncopal attacks, congestive heart failure and hypertrophic cardiomyopathy. Read about more heart related terms. 

Placing a pacemaker is a fairly complex procedure, here is why:
When a pacemaker is attached to a patient’s heart, the surgeon has to attach three leads to the different chambers of his/her heart. While placing two leads is simple, installing the third one takes some amount of skill. This is because the lead has to be fixed on the lower chambers of the heart which are behind or obstructed by a structure called the coronary sinus.

In the case of Mr Ananth the treating physician found that the third lead had shifted from the lower chambers (ventricles) to the upper chamber (atrium). Leading to breathlessness and discomfort.

Could your pacemaker lead  have shifted?

According to Dr Vanita Arora, Associate Director & Head-Cardiac Electrophysiology Lab & Arrhythmia Services at Max Super Speciality Hospital, Saket, ‘Pacing lead displacement and dislodgement is a relatively common problem and can occur in 5-10% of the patients*.  The leads may dislodge from the initial implant site in the first few days or few weeks following the implantation, which may be caused by the limited skills of the surgeon. Cardiac patients who have a pacemaker implanted must be careful about the following signs which might indicate problems in the pacemaker and can result in serious health implications if not detected early.’ 

If you have a pacemaker and are wondering if one of the leads might be displaced, here is a list of classic symptoms of the condition:

• Pain, bleeding, or bruising soon after the procedure
• Blood clots in your arms, which cause a lot of swelling
• Infection in your chest near the pacemaker
• Increased drainage, bleeding, or oozing from the insertion site
• If the wound appears to be opening at the incision site
• Redness, swelling or warmth around the incision (operation) site
• Fever or chills
• Dizziness
• Constant hiccups
• Fainting or nearly fainting often
• Fatigue
• Breathlessness

If you notice these symptoms make it a point to visit a doctor immediately. The complications of ignoring these symptoms could mean anything from severe breathlessness, permanent damage to your heart and – in some grave cases – death.

Source: http://health.india.com/diseases-conditions/could-your-pacemaker-be-malfunctioning-p214/