Pacemaker Surgery

An abnormal change in either the rate or pattern of the heartbeat is called arrhythmia (or dysrhythmia). When this happens, the heart may beat too slowly (bradycardia).


Bradycardia
(this is what Nathan has)

A heart rate that is "too slow" to meet the body's needs is called bradycardia (braid-a-card-e-ah). Bradycardia is most commonly caused by either heart block and/or sick sinus syndrome.


Heart Block (or AV Block)
(this is what Nathan has)

In heart block, the impulse that normally travels from the atria to the ventricles is either delayed or stopped. It doesn't mean the blood flow is blocked. It means that the flow of the electrical impulse within the heart is blocked.

Heart block can be either complete or incomplete. Nathan has complete heart block. With complete heart block, no electrical impulses reach the ventricles from the atria.


Type of Pacemaker

- A Dual Chamber Pacemaker
This is the pacemaker needed to correct Nathan's heart.
It has two pacing leads. One lead is placed in or on the atrium, and the other placed in or on the ventricle.




Pacemaker
Placement
- Epicardial
For Nathan the surgeon has chosen the epicardial method. With this method the lead is placed on the external (epicardial) surface of the heart.

The incision to place the leads will be
- under the arm pit (thoractomy)

The "pocket" for the generator (battery) will be made in the upper abdomen just under the rib cage.

The epicardial method is most often used in children whose veins are too small to use the transvenous method.


Tomorrow's Surgery
Nathan's surgery is scheduled for 7:30am. The biggest risk for this surgery is infection. If there is an infection the entire system will need to be replaced. Though Nathan's surgery is scheduled for 7:30am things will get started tonight. Around midnight Nathan will get a special bath that will cleanse him of bacteria. Sometime after that Nathan will have an IV placed. Then of course he will head off to the O.R. early to get set up and start sedation then head for surgery.

There is a possibility that Nathan's surgery will be cancelled tomorrow, however. The Surgeon came by awhile ago and informed us he has an emergency heart transplant this evening. Depending on how that goes and if the surgeon gets any sleep will depend on whether or not we get moved to the next day. I will update you all as soon as I know!

Thank you, Thank you, Thank you for all your thoughts and prayers!