Physiotherapy in patients with implanted cardiac pacemakers

Joanna Pająk, Rafał Młynarski, Jacek Durmała, Włodzimierz Kargul, Michał Plewa, Zbigniew Nowak

Joanna Pająk, Rafał Młynarski, Jacek Durmała, Włodzimierz Kargul, Michał Plewa, Zbigniew Nowak – Physiotherapy in patients with implanted cardiac pacemakers. Fizjoterapia Polska 2006; 6(3); 245-250

Abstract
Since the implantation of the first cardiac pacemaker in 1958 by Ake Sening and Rune Elmqvista, there has been gigantic progress in this field of medicine including both the range the equipment and the techniques of implantation. Today electrotherapy is a rapidly developing field of invasive cardiology. Cardiac pacemaker implantation is a very common procedure. Its popularity has increased year by year because the number of indicators is higher. This operation is often the only chance for patients suffering from heart rhythm disorders. In spite of the propagation this treatment method, rehabilitation of these patients is still underestimated. Meanwhile the role of the rehabilitation, as shown in some research, can be as crucial as properly programming the pacemaker. Special attention should paid to patients with implanted rate response devices. Our research shows that patients who are actively rehabilitated after the implantation procedure can get back to normal life more easily and that the number of complications which are connected with patients’ inability to understand of this method is lower. Cooperation between doctors and physiotherepeutists should be a standard. Unfortunately in the most cases it is only a theory. Meanwhile our experiences bring us in creation of standard procedures which are, in spite of patients’ opinion, very useful. There are many questions and queries connected both equipment and rehabilitation process of these patients. It must us to write this publication, where in complex form, implantation of cardiac pacemaker, characteristic of implanted patients and rehabilitation procedures were presented according to our and other authors opinion.

Key words:
physiotherapy, cardiac pacemaker, activity sensor

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Physiotherapy in patients with an implanted cardiac pacemaker

Włodzisław Kuliński

W. Kuliński – Physiotherapy in patients with an implanted cardiac pacemaker. FP 2017; 17(3); 28-36

 

Abstract

Background. In Poland, the number of patients with an implanted cardiac pacemaker equals over 100,000 and many of them undergo physical therapy and rehabilitation due to co-morbidities.
Material and methods. Sample electrocardiograms of various pacemaker pacing modes are presented. Cardiac pacemakers are sensitive to high-strength magnetic fields and electromagnetic fields generated by devices used in physical therapy.
Results. Short-wave diathermy may cause interference if the source of waves is located near the pacemaker site. Procedures using diathermy may inhibit pacemaker activity and cause heat damage to the generator (due to increased temperature). When a pulsed low-frequency magnetic field is used, the metal parts do not overheat, but there is a possibility of disturbances in the pacemaker function and thus it is recommended not to perform such procedures on the chest. The use of galvanic current, iontophoresis, and low and medium frequency currents is possible outside the area of the chest. There are no contraindications to light therapy and heat therapy. Electrical stimulation in patients with peripheral neuron damage may be used as long as special safety measures are followed.
The paper shows sample Holter monitor readings obtained when patients underwent various physical therapy procedures.
It also presents difficult cases of patients with an implanted cardiac pacemaker who require physical therapy and rehabilitation.
Conclusions. Most physical therapy procedures may be performed in patients with a pacemaker, but on condition that appropriate safety principles are followed.

Key words:
cardiac pacemaker, physiotherapy

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