Pacemaker after ASA or Myectomy
Sometimes after ASA or myectomy surgery it is necessary for you to have an implantable permanent pacemaker. This is due to inadvertent damage that may have been caused during the procedure to your hearts conduction system. This can happen as a complication approximately 10% of the time. If you require a permanent pacemaker, it will be implanted usually within 48 hours after your procedure. You will require a temporary pacemaker maintained through a catheter in your groin until your permanent pacemaker is implanted. Implantation of a permanent pacemaker is a simple procedure done in the cardiac cath lab and requires only light sedation. The generator unit pictured at right, is usually placed just under the skin on you upper left chest. There will be a wire passed through the veins in your neck area to the right side of your heart and then attached to the battery unit. The pacemaker will continuously sense your heart rate and deliver an impulse telling your heart to beat if the rate falls below a number set by your doctor. You will not feel the impulses delivered by your pacemaker. Your newly implanted system will be checked for proper functioning and then the small incision made for the battery will be closed using sutures. You will have restrictions on the use of your left arm for several weeks, but after that most pacemakers require very few life changes.
Dual Chamber Pacemaker
In some studies, the use of dual chamber pacemakers has been successful in partially relieving symptoms experienced by patients with HOCM. A dual chamber pacemaker is implanted much in the manor as described above, but involves an extra wire (lead) be placed. The pacemaker, as a treatment for HOCM, is designed to time the contraction of your heart muscle such that the bulging muscle in your septum does not contract and obstruct outflow until some blood has already been ejected.
Some patients who have HCM will require the implantation of a Cardiac Defibrillator. This is recommended for patients who exhibit some characteristics which place them at a higher risk for life threatening rhythm disturbances. A defibrillator will continually monitor heart rhythm and if it senses a rhythm that is life threatening it will deliver an electric shock to the heart in order to “reset” the heart back to a normal rhythm. Defibrillator implantation is very similar to that of a standard pacemaker, but involves a different type of programming.