Pacemaker in India with medical tourism: Overview
Medical tourism in India offers affordable Pacemaker for the patents
suffering from hear problem. Medical Tourism is one of the fastest
growing healthcare industries. The world is in a healthcare crisis and
patients are starting to travel overseas in search of the best quality
and the most affordable medical care. More and more Health
Insurance Companies, Employers, Claims Payers, and Health
Insurance Agents are looking at Medical Tourism as the creative
solution to the healthcare crisis. A recent report on Medical Tourism
stated that by 2017, over 16 million Americans could be traveling
overseas for medical care. With that being said, people from other
countries equal to or greater than that amount will also be traveling
around the world for medical care. Health care centers of Goa, Delhi
and Kerala provide most modern equipments available for
Pacemaker in India.
The pacemaker system includes the pacemaker itself and wires that
connect the pacemaker to the heart. The pacemaker unit is slightly
larger than a man’s wristwatch and contains a battery and computer
circuits. The computer circuits perform the functions of monitoring the
patient’s underlying heart rhythm and delivering an electrical signal to
cause the heart to beat at the desired rate. Many pacemakers
implanted today also may have rate responsiveness features that
allow temporary pacing of the heart at faster rates during periods of
exercise. Single-chamber pacemakers have only one wire
connected to the heart and dual chamber pacemakers have wires to
both the top and bottom chambers of the heart. Cardiologist in
India will recommend which type of pacemaker is needed. The
pacemaker is implanted by a minor surgical procedure performed
under local anesthesia. The wires are placed through a blood vessel
beneath the collar bone and positioned in the heart under x-ray.
The wires are then connected to the pacemaker, which is placed
beneath the skin just below the collar bone.
The surgery usually takes about 1 to 2 hours, and the risk
of surgical complications is about 1% to 2%. Usually only a small
bump in the skin is seen over the place where the pacemaker has
been implanted. Other than restrictions on heavy lifting and extreme
motion of the arm on the side of the pacemaker for several weeks,
recovery from the procedure is minimal. Most patients return to

normal activities within a few days. It is recommended from the
surgeons in India that patients carry an identification card that
provides specific information on the type of leads and pacemaker
implanted.
Reasons for pacemaker Implantation in India:
Almost all pacemakers are implanted to treat slow heart
beating, which is called "bradycardia." At rest, the heart usually
beats about 50 to 70 times each minute, and the heart rate may
increase 2- to 3-fold during stress or exercise. If the heart beats
too slowly, the brain and body do not get enough blood flow and a
variety of symptoms may result.
Artificial pacemaker in India:
An "artificial pacemaker" is a small, battery-operated device that
helps the heart beat in a regular rhythm. Some are permanent
(internal) and some are temporary (external). They can replace a
defective natural pacemaker or blocked pathway.
1. A pacemaker uses batteries to send electrical impulses to the
heart to help it pump properly. An electrode is placed next to the
heart wall and small electrical charges travel through the wire to
the heart.
2. Most pacemakers are demand pacemakers. They have a sensing
device. It turns the signal off when the heartbeat is above a
certain level. It turns the signal back on when the heartbeat is too
slow.
Different methods of Pacing in India:
1. Percussive Pacing:
Percussive Pacing, also known as Transthoracic
Mechanical Pacing, is the use of the closed fist, usually on
the left lower edge of the sternum over the right ventricle in
the vena cava, striking from a distance of 20 - 30 cm to induce
a ventricular beat. This is an old procedure used only as a life
saving means until an electrical pacemaker is brought to the
patient.
2. Transcutaneous Pacing:

Transcutaneous pacing (TCP), also called external pacing, is
recommended for the initial stabilization of hemodynamically
significantbradycardias of all types. The procedure is
performed by placing two pacing pads on the patient's chest,
either in the anterior/lateral position or the anterior/posterior
position. The rescuer selects the pacing rate, and gradually
increases the pacing current (measured in mA) until electrical
capture (characterized by a wide QRS complex with a tall,
broad T wave on the ECG) is achieved, with a corresponding
pulse.
3. Epicardial Pacing (temporary):
Temporary epicardial pacing is used during open heart
surgery should the surgical procedure create atrio ventricular
block. The electrodes are placed in contact with the outer wall
of the ventricle (epicardium) to maintain satisfactory cardiac
output until a temporary transvenous electrode has been
inserted.
4. Transvenous Pacing (temporary):
Transvenous pacing, when used for temporary pacing, is
an alternative to transcutaneous pacing. A pacemaker wire is
placed into a vein, under sterile conditions, and then passed
into either the right atrium or right ventricle. The pacing wire is
then connected to an external pacemaker outside the body.
Transvenous pacing is often used as a bridge to permanent
pacemaker placement. It can be kept in place until a permanent
pacemaker is implanted or until there is no longer a need for a
pacemaker and then it is removed.
5. Permanent pacing:
Permanent pacing with an implantable pacemaker involves
transvenous placement of one or more pacing electrodes
within a chamber, or chambers, of the heart. The procedure in
India is performed by incision of a suitable vein into which the
electrode lead is inserted and passed along the vein, through
the valve of the heart, until positioned in the chamber.
There are three basic types of permanent pacemakers,
classified according to the number of chambers involved and
their basic operating mechanism in India:

1. Single-chamber pacemaker. In this type, only one pacing
lead is placed into a chamber of the heart, either
the atrium or the ventricle.
2. Dual-chamber pacemaker. Here, wires are placed in two
chambers of the heart. One lead paces the atrium and one
paces the ventricle.
3. Rate-responsive pacemaker. This pacemaker has sensors
that detect changes in the patient's physical activity and
automatically adjust the pacing rate to fulfill the body's
metabolic needs.
Advantage in the function of Pacemaker in India:
A major step forward in pacemaker function has been to attempt
to mimic nature by utilizing various inputs to produce a rate-
responsive pacemaker using parameters such as the QT
interval, pCO - pCO2 (dissolvedoxygen or carbon dioxide levels)
in the arterial-venous system, physical activity as determined by
anaccelerometer, body temperature, ATP levels, adrenaline, etc.
Dynamic Pacemaking technology could also be applied to
future artificial hearts. Advances in transitional tissue welding
would support this and other artificial organ/joint/tissue
replacement efforts.
Many advancement have been made in India to enhance the
control of the pacemaker once implanted. Many of these
enhancements have been made possible by the transition to
microprocessor controlled pacemakers. Pacemakers that
control not only the ventricles but the atria as well have become
common.
Rate responsive pacing allows the device to sense the
physical activity of the patient and respond appropriately by
increasing or decreasing the base pacing rate via rate response
algorithms.
Why India?
India's top-rated education system is not only churning out
computer programmers and engineers, but an estimated 20,000

to 30,000 doctors and nurses each year. India has the potential
to welcome over a million medical tourists annually, says the
Confederation of Indian Industry (CII). India is a recent entrant
into medical tourism. Price advantage is, of course, a major
selling point. The cost differential across the board is huge: only
a tenth and sometimes even a sixteenth of the cost in the
West. If you or a loved one have a health problem that is causing
concern about the cost and quality of available care, Medical
tourism suggests you consider the excellent, high-quality
treatment options available to you in India at a fraction of the
cost in a U.S. hospital for pacemaker. To know more about
Pacemaker in India, please log on to:
www.indiacardiacsurgerysite.com or mail your queries at
info@indiacardiacsurgerysite.com, +91-9579119451
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