Centres/Interventional Cardiology/Pacemaker

Pacemaker implantation

Placement of a cardiac pacemaker that constantly watches over the heart rhythm and stimulates it whenever it beats too slowly.

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What is it?

The pacemaker is a small electronic device implanted under the skin, usually below the collarbone, and connected to the heart by one or more leads. It continuously monitors the heart rhythm and sends tiny electrical impulses as soon as the heart beats too slowly, thus guaranteeing a rhythm suited to the body's needs. Implantation is indicated when the heart shows excessive slowing or pauses: symptomatic bradycardia, conduction blocks, sinus node disease. These abnormalities can cause fatigue, breathlessness, dizziness or fainting, symptoms which the pacemaker eliminates by restoring an adequate rhythm. The procedure is short and well standardised, performed under local anaesthesia with light sedation. Today's pacemakers are discreet, have long battery life and automatically adapt to the patient's activity, allowing a completely normal life. At Clinique Pasteur Tunis, implantation is performed by a team specialised in heart rhythm care under rigorous aseptic conditions. A programme of regular device checks is then organised in consultation.

When is it indicated?

Symptomatic bradycardia (fatigue, dizziness, faintness)

When the heart beats too slowly and this results in unusual fatigue, dizziness or faintness, the pacemaker restores an adequate rhythm and makes these symptoms disappear.

High-degree atrioventricular blocks

When the electrical current no longer passes correctly between the upper and lower chambers of the heart, the pacemaker takes over to guarantee regular beats in all circumstances.

Sinus node disease with cardiac pauses

If the heart's natural pacemaker becomes deficient and pauses, the device keeps constant watch and intervenes as soon as the rhythm slows too much.

Documented syncope of slow rhythmic origin

When losses of consciousness are due to excessive slowing of the heart proven by recordings, pacemaker implantation effectively prevents recurrences.

Certain atrial fibrillations with slow conduction

In some patients with atrial fibrillation, the heart beats too slowly overall; the pacemaker then ensures a sufficient heart rate for daily life.

Preparation

1Cardiology work-up with ECG, Holter and echocardiography

2Blood tests including coagulation

3Adjustment of anticoagulants according to the physician's instructions

4Fast for 6 hours before the procedure

5Antiseptic shower the evening before and the morning of the procedure

Procedure

Positioning in a dedicated room, local anaesthesia and light sedation

Small incision below the collarbone

Introduction of the lead(s) through a vein under radiological guidance

Positioning of the leads in the heart and electrical tests

Connection of the device and closure of the pocket

Device check and verification X-ray

Duration

About 1 hour

Results

The pacemaker works as soon as it is placed and the symptoms related to the slow rhythm disappear rapidly. After 24 to 48 hours of monitoring, the patient goes home with simple instructions and a schedule of regular device checks.

Risks and side effects

Small bruise at the pocket, generally without consequence

Very low infection risk thanks to aseptic protocols

Rare lead displacement, corrected if necessary by a simple procedure

These risks remain rare. Your physician will inform you in detail before the examination.

Book an Appointment

Request a Quote +216 36 402 000

At a glance

Duration: About 1 hour

Preparation: Required

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