Педиатриялык кардиостимулятор: функциялары жана өзгөчөлүктөрү

By Криштиану Антонино On Dec 25, 2022

Кардиостимулятор – аритмиясы жана өтө жай болгон жүрөк ритми бар балдардын туура жүрөк ритмин калыбына келтирүүчү электрондук аппарат.

The pacemaker is an electronic device

It is implanted under the skin in children with arrhythmia, whose heart rhythm is too slow.

In this condition, the oxygenated blood that is pumped from the heart is thus insufficient to meet the body’s needs and causes symptoms such as:

Алсыздык;
Уйкусуроо;
баш айлануу;
Breathlessness even for minimal efforts;
Pre-syncopes and syncopes.

In these children, the pacemaker is able to restore the right heartbeat by sending electrical impulses that make the heart contract artificially, at the heart rate required by the physical activity the child is doing.

БАЛДАРДЫН ДЕН СООЛУГУ: ЧУКУЛ ЭКСПОдо ЭКИ САПАРГА БАРЫП МЕДИЧИЛДИК ЖӨНҮНДӨ КӨБҮРӨӨК БИЛИҢИЗ

A pacemaker basically consists of 3 parts:

Батарея;
A computerised pulse generator. Battery and pulse generator are enclosed within a small metal container, somewhat larger than the size of a two euro coin;
One or more small cables with sensors (electrodes) at one end, called leads.

The pulse generator is the source of the electrical impulses that normalise the altered heart rhythm; the leads, on the other hand, are the connections that link the generator to the heart and allow the electrical impulses to be transmitted to the heart muscle.

КУТКАРУУ БОЮНЧА ОКУУНУН МААНИЛҮҮЛҮГҮ: SQUICCIARINI КУТКАРУУ КҮЧҮНҮНӨ БАРЫҢЫЗ ЖАНА ӨЗГӨЧӨ КЫРДААЛГА КАНТИП ДАЯРДАНУУ КЕРЕК БИЛИҢИЗ

The pacemaker generator is implanted under the skin

In children weighing more than 20 kg, the implantation of the generator takes place in the thoracic area, under the clavicle, with the leads going to stimulate the internal surface of the heart cavities (endocardial implantation) passing through the large veins: the subclavian vein and the superior vena cava to reach the right atrium and then the right ventricle of the heart.

Салмагы 15-20 кгдан ашпаган балдарда жана венадан жүрөк камераларына жетүүгө мүмкүн болбогондо, имплантация ордуна жүрөктүн сырткы бетине сымдарды жайгаштыруу менен кардиохирургиялык операция (эпикардиалдык имплантация) болуп саналат. жана генератор курсак деңгээлинде тери астындагы чөнтөккө жайгаштырылган.

Once the implantation of the leads and the metal container has been completed, and their connection made, the pacemaker must be programmed.

Programming is carried out using a special computerised instrument and depends on the heart problem the patient is suffering from.

After setting, the pulse generator must be checked periodically to ensure that it is working properly.

ЖҮРӨКТҮ КОРГОО ЖАНА ЖҮРӨК-ӨПКӨ РЕАНСИТАЦИЯСЫ? КӨБҮРӨӨК БИЛҮҮ ҮЧҮН EMD112 BOOTH ЭМНЕ ҮЧҮН ЭКСПОГО БАРЫҢЫЗ.

Implanting a pacemaker is a fairly safe operation

However, like any surgery, it can have immediate complications such as:

Infections at the site where the pacemaker is inserted;
Allergic reactions to the anaesthetic drugs used during the procedure;
Damage to blood vessels, crossed by the leads, or to nerves located near the pacemaker;
Pulmonary collapse from haemorrhage or infiltration of air between the pleural leaflets lining the lung;
Perforation of the myocardium;
Swelling, haematomas and haemorrhages at the level of the pacemaker pocket.

Follow-up of the paediatric patient after surgery

The pacemaker should be checked by the doctors and technicians on a regular basis (about every 6 months), as this can happen over time:

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The cables may move or break;
The heart condition may worsen;
The battery may become discharged or malfunction.

Pacemaker batteries can last from 5 to 15 years (on average they last 6 or 7 years), depending on the activity of the device.

The doctor must replace the generator and the battery before the latter starts to wear out.

Some functions, including the battery status however, can also be controlled remotely via telemedicine.

It is also necessary to take a chest X-ray every 2 years to check the position and degree of tension of the leads, which may increase as the patient grows.