The Old Pacemaker Precautions
Old pacemaker precautions were usually not easy for patients to be compliant with. After their procedure, patients were expected to limit the use of their arms for reaching, pushing, pulling, etc with their ADLs. By the time patients learned their pacemaker precautions, they were probably no longer necessary. Oftentimes, patients with cognitive deficits and/or old age have difficulty complying with their pacemaker precautions and may never learn them. There are also many other barriers to compliance with pacemaker precautions including education for the healthcare staff, caregivers, and students.
Besides therapy precautions for OT and PT, the “old” pacemaker also had some downsides. They were visible from the outside (detectable, palpable) and in terms of size, were relatively large on the upper chest. Patients had a bump or visible scar from the implantation. There are activity restrictions and lifestyle changes. Medically, it presented additional challenges such as precautions for use in MRI machines. The list goes on and on.
The New Technology
Enter the Micra (Micra AV and Micra VR). For therapists, it is a gamechanger. Why? Patients with the Micra pacemaker no longer have pacemaker (sternal) precautions. By nature of where the device is implanted, there is no scar or bump on the chest. The device is implanted directly inside the heart chamber via catheters.
The Micra is 93% smaller than regular pacemakers.
Patients will typically require bed rest (1 day) after the procedure and should be cleared to ambulate and participate in regular activity (if cleared by the doctor). With patients no longer having to adhere to pacemaker precautions, as the Micra pacemakers become more prevalent, therapists may be out of the job!? 🙂
While this is not necessarily true and therapists will still play a major role in maximizing the function of patients now with a cardiac history. Instead now, therapists can focus on the ADLs, IADLs, or whatever the patient’s goals are in recovery.