One of the more common questions a patient has when using electrotherapy devices is whether it will interfere with their implanted demand cardiac pacemaker. The question is very reasonable due to the way a demand heart pacemaker works.
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How A Demand Cardiac Pacemaker Works:
A heart demand pacemaker is an implanted device that uses a battery powered stimulator, connected to wires, and the wires are strategically placed to stimulate heart muscles. The pacemaker itself is also what is called a "biofeedback" type device because the pacemaker actually is monitoring the continuing electrical output of the heart muscles as they contract. The pacemaker detects the electrical charges emitted by the heart muscles when they pump, contract to move the blood.
If the demand pacemaker fails to discern electrical activity over a pre-set time period then it is assumed the heart has stopped and an electrical stimulus is emitted by the battery, down the wires to the heart nerves to stimulate the heart to restart pumping blood. Many patients who have the pacemakers installed testify to feeling the surge of electrical energy at times to stimulate their heart. It is a life saving device.
The Danger Of A Tens Machine With A Demand Pacemaker:
The issue one has with electrical devices, such as tens units (transcutaneous electrical nerve stimulators), is the tens unit is constantly emitting electrical messages/signals and those signals may interfere with the pacemaker sensing the lack of electrical stimulus by the heart muscles themselves. The tens unit electrical discharge will be going on and on so the pacemaker assumes those same electrical currents are coming from the heart and therefore does not stimulate the heart muscles and the patient dies.
The general rule is to not apply tens type electrodes in the chest area simply as a safeguard that effect will not happen. The tens machines, and many other devices customarily say "do not use if wearing a pacemaker". Now not all pacemakers are "demand" type however the vast preponderance are. The truth though is most tens units and many portable electrical devices simply do not have the electrical energy to penetrate and interfere with what the pacemaker is monitoring. Most tens devices hardly penetrate the skin, much less deep within body tissues and cavities.
Generally speaking if the electrodes are placed away from the chest area then most medical doctors do not worry about electrical interference and failure of the pacemaker to stimulate.
More Powerful Clinical Electrical Devices
Today we have portable devices that are used for the same reasons a tens unit is used and most of these devices are demonstrably better for the condition related than tens. One such electrotherapy device is the portable interferential device the patient takes home for self treatment. Unlike a tens unit which goes off and on at most 150 times per second, the interferential device goes off and on 8,150 times per second. The output is significantly greater and the depth of penetration is also. Clinical interferential devices have been used since 1953 with patients and there has been no reported interferences with demand pacemakers I'm aware of. The essence of interferential is to have a high "rate" (off and on) as this allows better penetration of the electrical charges جراحة القلب المفتوح to the actual areas where electrical energy is needed. The physics of this higher rate dictates the efficacy is derived from the ability to deliver electrical currents deeper into the tissues and toward the targets within the body.
The benefit of the interferential machine is the treatment time is measured in minutes so a patient can self treat for 20 - 60 minutes and that may be all that is necessary for 24 hours. Over time, and ability to self treat to prevent pain etc., the use of an interferential device is not needed since the condition improves and fewer treatments are needed. This is contrasted to a tens machine which is worn continuously, sometimes 24 hours per day, and there is constant electrical energy versus the 20 - 60 minute time periods of interferential therapy. The constant output of a tens unit is considerably greater time than an interferential unit which provides carryover pain relief.
Conclusion:
As with all medical devices one should follow the directions given. Always inform the treating physician if you have a demand type cardiac pacemaker before beginning treatments so you can be monitored. The benefits of short daily interferential sessions, once found successful in the clinic, may be warranted with a take home device, even when one wears a demand cardiac pacemaker. This is especially true if pain is being experienced in the legs, low back, sciatica, neck, shoulders, feet and other areas away from the chest.
If you have had a heart attack or heart-related illness, you should talk with your doctor about cardiac treatment options. Depending on your current abilities, your doctor will work out a plan to strengthen your heart and get you as healthy as possible. As you talk with your physician, ask questions so that you fully understand the pros and cons of each of the cardiac treatment options available to you.
Non-Invasive
If your illness is mild or you are otherwise relatively healthy, you may benefit simply from making a few lifestyle changes. You may be prescribed some medications that can help control cholesterol, blood pressure, or regulate your heartbeat. You may also be referred to a nutritionist or someone who can help you think about your eating habits and how small changes might affect your overall health. An exercise program, monitored by your physician, is also a recommendation for many patients.
While not invasive, you should still ask your health care professional especially about the recommended medications. Make sure you fully understand what the medication will do for you, and any potential side effects. If there are fairly well-known side effects, then ask about options that may minimize your risk of having them. If you decide to enroll in an exercise program, ask your doctor to detail out the level of activity you should begin with, and how they would like to receive regular reports of progress.
Minimally Invasive
If medication, diet, and exercise modifications are not enough, there are some minor procedures that may be offered as cardiac treatment options. If you are having issues with chest pain or pressure, or other signs of heart disease, you may be recommended for a heart catheterization. In this procedure, a tube is inserted through the arteries in the legs or arms, reaching into your heart. The doctor uses special tools to inject dye, clear clogged arteries, or insert a stent to open up the artery. While this procedure is done in a hospital, the patient can usually go home the same day, and rest for the next several days.
If your doctor is recommending a minor procedure like this, make sure you understand why. Have they ruled out other reasons for chest pain by performing an EKG or stress test? If they can reassure you that it is a necessary diagnostic tool, then you need to ask for details about preparing for the catheterization, what you can expect that day, and what you can expect after it is over.
Surgical Procedures
Sometimes simply clearing out the arteries and inserting a stent are not enough. In that case, one of your cardiac treatment options may be surgery to repair or replace whatever organ is causing your heart issues. This may involve repairing damage to heart tissue, valves, arteries or the vessels. You will likely be in the hospital for several days, and then a recovery period of perhaps several weeks.
Ask questions about the risks of the procedure itself, the success rate of it helping with your type of problem, and what you can expect during recovery. Your doctor should be able to tell you about other patients with similar patients, and how they have been since the procedure.
Advances in science and medicine mean that new cardiac treatment options are becoming available every day. It is your responsibility to ask questions and get all the information you need to feel comfortable you fully understand your choices. It is ultimately your decision, so you must weigh the benefits as well as the risks of each option carefully.