Pacemaker in Sharjah

What is a pacemaker?

A pacemaker is a small device, about the size of a matchbox or smaller, placed under the skin just below the collarbone. One or more thin wires, called leads, run through a vein to the heart. Some newer pacemakers are leadless and sit directly inside the heart. The pacemaker watches every heartbeat and sends a tiny electrical signal only when the heart's own rhythm is too slow or pauses.

At Dar Al Kamal Hospital, Sharjah, the cardiology team finds out whether a slow heart rhythm is causing your symptoms and whether a pacemaker is the right treatment. Pacemaker implantation itself takes place at a specialist centre with a cardiac catheter or device laboratory, and your cardiologist arranges the referral. Your general cardiology care, including your other heart conditions, blood pressure and medicines, continues at Dar Al Kamal Hospital, Sharjah.

Who needs it

A pacemaker is usually recommended for a heart rhythm that is persistently too slow or that pauses, when this causes symptoms or carries a risk of sudden collapse. The two most common causes are:

• Heart block, where the electrical signal from the top chambers of the heart is delayed or stopped on its way to the bottom chambers
• Sick sinus syndrome, where the heart's natural pacemaker fires too slowly or irregularly, sometimes alternating with fast rhythms

Symptoms that lead people to this assessment include dizziness, fainting or near-fainting, unusual tiredness, breathlessness on light activity and confusion in older people. Fainting without any warning can be the only sign of a slow rhythm, so it is always worth investigating.

Some people with heart failure benefit from a special pacemaker that coordinates both sides of the heart, called cardiac resynchronisation therapy. Others at risk of dangerous fast rhythms need an implantable defibrillator. Both are also fitted at specialist centres after referral, and your cardiologist explains which, if any, suits you. Heart failure care is described on the heart failure management page.

What happens

Your cardiologist reviews your symptoms, medicines and history. Some medicines slow the heart, so a review of your current tablets is part of the assessment. An ECG records your heart rhythm at rest, and an echocardiogram shows how well the heart muscle pumps. Because slow rhythms often come and go, a Holter monitor worn for one or more days at home records your rhythm while you go about normal life.

If the tests show a rhythm problem that a pacemaker would treat, your cardiologist explains the reasons, the type of device likely to be recommended and what implantation involves. You then receive a referral letter with your test results to a specialist centre that performs pacemaker implantation.

At the implanting centre, the procedure is usually done under local anaesthetic with sedation. The team makes a small cut below the collarbone, guides the lead into the heart using X-ray imaging, connects it to the pacemaker and places the device in a small pocket under the skin. Many people go home the same day or the next day, as the implanting team advises.

Preparing for it

Bring every medicine you take, including any heart-rate or blood-thinning tablets, and any previous ECGs, Holter reports and discharge letters. Keep a simple diary of dizzy spells or faints: the date, what you were doing, and how long it lasted. This helps your cardiologist match your symptoms to the recordings.

If you have fainted, do not drive until your cardiologist has reviewed you. Driving rules after fainting and after a pacemaker are set by UAE licensing guidance, and your cardiologist advises you on when it is safe to return to driving.

The implanting centre gives its own instructions on fasting and blood-thinning medicines before the procedure. Ask about these at the referral stage so nothing is changed without advice.

Afterwards

After implantation, the implanting team gives advice on caring for the wound and on how much to move the arm on the pacemaker side while the leads settle. Pacemaker checks, in which the device settings and battery are read, are carried out at the implanting centre or a device clinic, and your cardiologist at Dar Al Kamal Hospital, Sharjah coordinates the rest of your heart care alongside them.

Everyday life with a pacemaker is usually close to normal. Keep your mobile phone and headphones at least a hand's width away from the device, holding the phone to the ear on the opposite side. Carry your pacemaker identification card and show it at airport security. Tell every doctor, dentist and scanning department that you have a pacemaker; an MRI scan is possible only when the device is designed for it, as explained on the MRI scan page.

Contact the hospital if the wound becomes red, swollen, hot or leaks fluid, if you develop a fever, if you have hiccups that will not stop, or if your dizziness, breathlessness or tiredness returns. Call emergency services or go to the emergency department straight away if you faint and injure yourself, faint again after your pacemaker is fitted, or have chest pain.

Cost and insurance

Most UAE health insurance plans cover cardiology consultations, ECGs, Holter monitoring and echocardiograms, with some tests needing pre-approval. Pacemaker implantation at the referral centre requires separate pre-approval, and the device itself is often assessed as part of that approval. Dar Al Kamal Hospital, Sharjah can help you confirm your cover for the assessment on 06 599 7777.