Biventricular Pacemaker (Heart Failure Device Implantation)
Steps Involved in IVF:
Procedure Description
A biventricular pacemaker, also known as cardiac resynchronization therapy (CRT), is an advanced device implanted in the chest to treat heart failure. This device synchronizes the contractions of both ventricles, enabling them to work together effectively and pump blood more efficiently. Heart failure, characterized by the heart's inability to pump blood at adequate levels, affects millions worldwide and can lead to debilitating symptoms like breathlessness, fatigue, and edema. Traditional pacemakers target only the heart's right side, but a biventricular pacemaker involves leads placed in both ventricles, ensuring synchronous beats, which significantly improves the patient's quality of life.
The implantation process involves placing small electrodes, or leads, in the right atrium, right ventricle, and the left ventricle via the coronary sinus vein. These electrodes are connected to a pulse generator implanted under the skin near the shoulder. By monitoring the heart's rhythms, the device ensures that each side of the heart beats simultaneously, improving blood flow and relieving heart failure symptoms. Often, patients with left bundle branch block or conduction abnormalities, where the ventricles beat out of sync, benefit the most from this therapy.
The procedure typically requires a team of skilled cardiac electrophysiologists, technicians, and nursing staff to ensure successful placement and synchronization of the device. Not all heart failure patients are candidates for a biventricular pacemaker. Eligible patients usually have moderate to severe heart failure, left ventricular ejection fraction below a specific threshold, and prolonged QRS duration on the electrocardiogram (EKG). Once implanted, the pacemaker reduces symptoms, improves exercise tolerance, and decreases the risk of hospitalization due to heart failure.
Procedure Duration
Biventricular pacemaker implantation is generally a minimally invasive procedure that takes approximately two to four hours to complete. Patients are typically awake but sedated, with local anesthesia administered to numb the area. The procedure begins with the insertion of a catheter into a major vein, commonly the subclavian or cephalic vein. Using fluoroscopy (live X-ray), the cardiologist advances the catheter to position the leads within the heart chambers.
After securely placing the leads in the desired locations, the surgeon connects them to the pulse generator, a small device usually implanted under the skin near the collarbone. This generator monitors the heart's electrical activity and sends signals to keep both ventricles synchronized. Testing the device for accurate functioning concludes the implantation procedure. In some cases, adjustments are made to ensure optimal performance before the incision is closed.
Recovery time following implantation is generally short, but patients are advised to take precautions during the initial weeks. Most patients stay in the hospital for one to two days for monitoring. Light activities are encouraged after one week, while more strenuous activities may require a recovery period of four to six weeks. The biventricular pacemaker's battery usually lasts five to seven years, after which replacement is needed through a minor surgical procedure.
Benefits
- Enhanced Heart Efficiency: The device improves synchronization of the heart's ventricles, enhancing blood flow and reducing symptoms of heart failure.
- Reduced Hospitalizations: Patients with biventricular pacemakers experience fewer hospital visits and emergency care requirements for heart failure.
- Improved Quality of Life: The reduction in heart failure symptoms, such as breathlessness and fatigue, enhances overall life quality and functional capacity.
- Prolonged Life Expectancy: CRT has shown to increase survival rates among eligible patients by stabilizing heart function.
- Better Exercise Tolerance: Patients often report improved exercise capability, as the device supports increased blood flow and oxygen delivery during physical activities.
Potential Destinations
India
India is renowned for its expertise in cardiac procedures, with internationally trained cardiologists and modern facilities. Many Indian hospitals offer high-quality CRT services at a fraction of the cost compared to Western countries, making it an attractive option for medical tourists.
Turkey
Turkey has become a leading destination for heart-related treatments, including pacemaker implantations. Its state-of-the-art healthcare infrastructure, particularly in cities like Istanbul, and highly skilled cardiologists make Turkey a preferred destination for cost-effective and quality cardiac care.
Thailand
Thailand is celebrated for its world-class medical tourism facilities. Hospitals in Bangkok and other major cities provide comprehensive CRT services with advanced technology and highly skilled staff, making it a popular choice for those seeking heart care at competitive rates.
Mexico
For North American patients, Mexico offers convenience and affordability in cardiac treatments, including biventricular pacemaker implantations. With well-equipped hospitals near the U.S. border, Mexico combines quality care with ease of access for international patients.
Germany
Known for its cutting-edge technology and rigorous standards, Germany is a popular choice among European and international patients for CRT and other advanced cardiac procedures. Hospitals in major cities provide excellent care, although treatment costs are typically higher than in Asia or Latin America.
Risks & Considerations
- Lead Displacement: One of the most common issues post-implantation is lead displacement, where the electrodes move from their intended positions, which may require repositioning.
- Infection: As with any surgery, there is a risk of infection at the incision or implant site, which may require antibiotic treatment or, in severe cases, device removal.
- Device Malfunction: Pacemakers can occasionally malfunction, leading to irregular heart rhythms. Regular follow-ups help monitor and rectify any device issues.
- Allergic Reactions: Some patients may experience allergic reactions to the materials used in the pacemaker or the medications administered during the procedure.
- Blood Clots: Although rare, blood clots can form around the leads or in the vein where the device is implanted, leading to complications that may require additional treatment.
How to Choose the Right Doctor and Hospital
When selecting a doctor and hospital for biventricular pacemaker implantation, it is essential to consider the expertise and experience of the cardiology team. Look for hospitals with dedicated cardiac electrophysiology departments and professionals trained in implanting and managing heart devices. Reviews, certifications, and patient testimonials can provide insight into the quality of care offered by the facility.
Furthermore, ensure the hospital has advanced imaging and monitoring capabilities, as these are essential during both the implantation and follow-up phases. Consulting with a cardiologist who has specific experience with CRT can significantly impact the outcome of the procedure, as their expertise contributes to accurate device placement and effective patient management.
To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote
Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com
Frequently Asked Questions
What actually happens during hyperstimulation of the ovaries?
The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.
What happens during egg retrieval?
When the follicles have developed enough to be harvested, the patient attends an appointment where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.
What happens to the eggs?
In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle. Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.
How are the embryos transferred back to the uterus?
The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.
Embryoscope©
Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.
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