Do I need a pacemaker?

The world of pacemakers is quiet complex. Some people develop abnormal heart rhythms- the heart may suddenly go fast or too slow. When the heart rate is fast, one can take medications. However, when the heart rate is too slow, there are no medications that can be used on a daily basis at home. Slow heart rate can be treated in a hospital setting with intravenous drugs. There is no pill that can effectively increase heart rate.

So now, we have pacemakers. There are many types of pacemakers and they can cost anywhere from $8,000-$30,000. The type of pacemaker you need is determined after studies on your heart. Pacemakers are life saving. The procedure to insert a pacemaker is very simple and rarely takes more than 30-45 minutes (unless your doctor is incompetent). The procedure can be done under local anesthesia and is not painful at all. It involves placing a small thin wire (electrode) in one of the chambers of your heart. The procedure is always done using x rays to ensure that the electrode is inserted into the correct anatomical position. Then a miniature pacemaker (about the size of a credit card) is inserted beneath the skin in the chest. The electrode is then connected to the pacemaker. The pacemaker is programmed and you are all set. Today, pacemakers have saved countless lives and work well for 7-12 years. Only the battery needs to be changed every 5-10 years.

Pacemakers can be inserted at any age and the risks are minimal. In the past, there have been a few doctors who allegedly have inserted pacemakers for trivial reasons (like making more money). Today, there are strict Medicare rules on who can receive a pacemaker. If you have been told by your physician you need a pacemaker, discuss the issues with a cardiologist (heart doctor). After a pacemaker, you will definitely notice a difference in your overall health.

I was told to take antibiotics before my dental cleaning, Why? part 2

Now the American Heart Association has come up with new guidelines and recommend a short-term course of antibiotics only for individuals who are at a high risk for developing a bacterial infection of the valves. These include people with:

- A mechanical prosthetic heart valve
- Natural prosthetic heart valves obtained from animals
or cadavers
- Valve repair using prosthetic material
- A prior history of infective endocarditis
- Most congenital (from birth) heart abnormalities,
even if the abnormality has been repaired

Individuals who are at low risk and do not require antibiotics include the following?

- Those with innocent heart murmurs
- Mitral valve prolapse without regurgitation
or valvular leaflet thickening
- Mild tricuspid regurgitation
- Individuals with Coronary artery disease or
those who have undergone bypass surgery
- Simple atrial septal defect (hole in the heart)
- Individuals who undergo angioplasty or ballooning
of their coronary vessels
- Those with prior history of rheumatic fever but
normal valves
- Those who have pacemakers or other similar devices

In the low risk group, it is now believed that antibiotics are unnecessary and may cause more health problems such as allergies.

Individuals who are at risk of developing infective endocarditis should maintain good oral and dental hygiene. This may include a visit to the dentist for a check up, regular tooth brushing and use of dental floss. These preventive measures can prevent plaque-forming bacteria from sticking to your gums and teeth