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How Is A Pacemaker Implantation Procedure Performed?
Question: Hello Cardiologist,
Say you had a patient that needed a pacemaker put in. This patient is technically willing to have it done but is terrified of surgeries of any type, doesn't matter if she is awake or completely knocked out. There are sever factors that contribute to this fear that will set off server panick attacks, if she just thinks about it, let alone probably couldn't get herself to go to the hospital the day of the surgery...in a way she would rather be knocked out because of the anxiety and panic but of course she knows pacemaker are put while patient is just sedated.
All the factors are related to her being sedated, thus incapable of protecting herself. Yes she was abused in every way during her childhood and raped while she was in a hospital when she was 14.
She would be dead already, if the state of California didn't have a law where Dr's could get court orders to do a surgery, if the person's life was in danger. She refused to sign paperwork for surgery when she was having an appendicitis. She even tried to get off the operating table to run off, when the sedative they gave her wore off before they had her put under.
For one, would you want her to tell you why she is refusing a surgery, she admits she needs and knows would improve her quality of life? If she opened up to you, what would/could you do to help her? Would you even want to help? Is there anything you could do with the staff to add to her feeling safer during her time in the hospital and during the surgery? Not even sure what other questions to ask because have no idea what could be done to help her.
Say you had a patient that needed a pacemaker put in. This patient is technically willing to have it done but is terrified of surgeries of any type, doesn't matter if she is awake or completely knocked out. There are sever factors that contribute to this fear that will set off server panick attacks, if she just thinks about it, let alone probably couldn't get herself to go to the hospital the day of the surgery...in a way she would rather be knocked out because of the anxiety and panic but of course she knows pacemaker are put while patient is just sedated.
All the factors are related to her being sedated, thus incapable of protecting herself. Yes she was abused in every way during her childhood and raped while she was in a hospital when she was 14.
She would be dead already, if the state of California didn't have a law where Dr's could get court orders to do a surgery, if the person's life was in danger. She refused to sign paperwork for surgery when she was having an appendicitis. She even tried to get off the operating table to run off, when the sedative they gave her wore off before they had her put under.
For one, would you want her to tell you why she is refusing a surgery, she admits she needs and knows would improve her quality of life? If she opened up to you, what would/could you do to help her? Would you even want to help? Is there anything you could do with the staff to add to her feeling safer during her time in the hospital and during the surgery? Not even sure what other questions to ask because have no idea what could be done to help her.
Brief Answer:
My answer as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I am sorry to hear about this sad history, but I would like explain that this is not a procedure done under sedation.
Pacemaker implantation is done under local anesthesia, just in the point where the catheter enters into your vessels.
So during all the procedure the patient is awake and able to hear and talk to the medical team, who are making the implantation.
The patient can hear, talk and move his body. He is capable of doing everything.
So there is nothing to worry about! If I were her doctor, I would explain her carefully all this procedure.
For more information, I would recommend watching an informative video with all you should know about this procedure:
https://youtu.be/SCc6Ys6LF44
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I am sorry to hear about this sad history, but I would like explain that this is not a procedure done under sedation.
Pacemaker implantation is done under local anesthesia, just in the point where the catheter enters into your vessels.
So during all the procedure the patient is awake and able to hear and talk to the medical team, who are making the implantation.
The patient can hear, talk and move his body. He is capable of doing everything.
So there is nothing to worry about! If I were her doctor, I would explain her carefully all this procedure.
For more information, I would recommend watching an informative video with all you should know about this procedure:
https://youtu.be/SCc6Ys6LF44
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Ilir Sharka,
She told me the procedure was done while patient was in twilight. That's when I suggested to her to tell her Dr. her concerns and why. I told her I had a procedure done a few years ago where I told my Dr. my concerns because of something that happened to me and being helpless causes me anxiety. Told her my Dr. setup things to help me feel safe, my room was directly infront of nursing unit, no male staff were allowed in my room without a woman staff, he had his PA right next to me during procedure, talking with me the whole time, he even had a woman anesthesiologist asigned and released me faster than he normally would of...no moved in that room until the PA told me they were and why
She was hoping that someone would respond with some ideas similar to those. I will have her watch the video but sadly, I think her not being at least somewhat out of it, is going to trigger other fears and concerns.
She told me the procedure was done while patient was in twilight. That's when I suggested to her to tell her Dr. her concerns and why. I told her I had a procedure done a few years ago where I told my Dr. my concerns because of something that happened to me and being helpless causes me anxiety. Told her my Dr. setup things to help me feel safe, my room was directly infront of nursing unit, no male staff were allowed in my room without a woman staff, he had his PA right next to me during procedure, talking with me the whole time, he even had a woman anesthesiologist asigned and released me faster than he normally would of...no moved in that room until the PA told me they were and why
She was hoping that someone would respond with some ideas similar to those. I will have her watch the video but sadly, I think her not being at least somewhat out of it, is going to trigger other fears and concerns.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
You should know that not in every hospital it is possible to be treated by a medical team formed only by women.
You may try to find a similar hospital, or try the hospital you were treated with your doctor. Besides, in every hospital the doctor talks with the patient during the procedure and the patient is alert during all the procedure.
But, even though I can explain all these thing, I think her problems go far more deeply than that.
That is why I think that in this situation consulting with a psychiatrist would be useful.
There are several behavioral psychotherapies, which can help her face with her fears.
From the other hand antidepressant and benzodiazepines could be helpful.
You should try to convince her to consult with her psychiatrist and discuss these fears.
You should tell her that pacemaker implantation can change her quality of life, giving the chances of a normal like (not like a cardiac patient waiting for an arrhythmia to occur, with a restricted physical activity). That is why she should think twice and try to manage her fears, before giving up.
Hope you will find this answer helpful!
Best wishes,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
You should know that not in every hospital it is possible to be treated by a medical team formed only by women.
You may try to find a similar hospital, or try the hospital you were treated with your doctor. Besides, in every hospital the doctor talks with the patient during the procedure and the patient is alert during all the procedure.
But, even though I can explain all these thing, I think her problems go far more deeply than that.
That is why I think that in this situation consulting with a psychiatrist would be useful.
There are several behavioral psychotherapies, which can help her face with her fears.
From the other hand antidepressant and benzodiazepines could be helpful.
You should try to convince her to consult with her psychiatrist and discuss these fears.
You should tell her that pacemaker implantation can change her quality of life, giving the chances of a normal like (not like a cardiac patient waiting for an arrhythmia to occur, with a restricted physical activity). That is why she should think twice and try to manage her fears, before giving up.
Hope you will find this answer helpful!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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