Pacemakers

A pacemaker is a small battery powered device that helps your heart beat more regularly.  It does this by sending electrical signals from the device through wires into the heart. The doctor will put the pacemaker under the skin in the chest, just under your collarbone. Tiny wires are attached and lead from the device to the heart through veins in the chest.

How to get ready for a pacemaker procedure

•         Do not eat or drink anything after midnight the night before the procedure, or 8 hours before the procedure or as directed by your healthcare provider.

• Tell your doctor about any allergies to medicines, shellfish or iodine contrast, tape or adhesives, or antibiotic types of soaps. Alternatives can be provided and precautions can be taken to avoid exposing you to anything that you are allergic to.
• Follow your healthcare provider's instructions on what medicines to take. If you are taking a blood thinning medicines, your healthcare provider may give you instructions on stopping it before the procedure to decrease the risk of major bleeding. You may be instructed to stop medicines that interact with the contrast dye that is used to place the pacemaker wires in the vein.
• You may be given an antibiotic through an IV to protect you from an infection.
• You will have blood drawn depending on your overall health. If your kidney function is not normal, special precautions may be needed before the procedure.
• If you are a woman of child-bearing age you may be asked to take a pregnancy test before the procedure.

What happens during the procedure

•         Your doctor may prescribe a medicine to help you relax and to prevent pain during the procedure.

• A local anesthetic is given by injection to numb the area where the pacemaker will be inserted. This keeps you from feeling pain during the procedure.
• The doctor will make a cut (incision) where the generator will be placed.
• The doctor will guide the wire (lead) through a vein into your heart’s chambers using X-ray monitors.
• The doctor will attach the pacemaker generator to the lead or leads.
• The doctor will close the incision site with stitches and may seal the site with a surgical glue to prevent infection.
• A dry sterile dressing will also be applied over the incision to reduce the risk of bleeding and also protect it from infection.
• The pacemaker’s settings will be programmed by your doctor to help your heart beat at a rate that’s right for you.

What happens after the procedure

• You will stay in the hospital overnight. While you are in the hospital, your heart’s rate and rhythm will be monitored to see how the pacemaker is working.
• You will have a chest X-ray before you go home. This is to check that the pacemaker leads (wires) are in the correct position.
• Your pacemaker settings will be rechecked and may also be reprogrammed. You can go home when your condition is stable.

Once you get home:

• Follow your discharge instructions to care for your incision. Watch for signs of infection (see box).
• Follow any special instructions to care for the side of your body where your pacemaker was implanted. Your doctor may tell you not to raise that arm above the shoulder for a certain amount of time.
• You will likely have bruising at the incision site. This is normal and will go away as the incision heals.
• You can probably return to your normal routine soon after implantation. Ask your doctor when you can return to work.
• Ask your healthcare provider when it will be safe to shower, bathe or swim. Generally, you should not soak in water for about a week to prevent the incision from softening, opening or becoming infected.
• Avoid all activities that would put pressure on your incision site or cause irritation to the incision.
• Do not use lotions, powders or ointments unless your healthcare provider says it is safe to do so.
• Do not carry a purse or backpack that would put pressure on the incision site.
• See your doctor for follow up visits as instructed.