PACEMAKER IMPLANTATION

A pacemaker is a small device that sends electrical impulses to the heart muscle to maintain a suitable heart rate. Your doctor programs the pacemaker to meet each patient’s individual needs.

Pacemakers are used to treat:

Bradyarrythmias (Heart rates that are too slow)

Heart failure / Heart Block

Hypertrophic cardiomyopathy

What to Expect: When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry or valuables at home. You will lie on a bed and the nurse will start an intravenous line (IV) into your arm or hand. This is so you may receive medications and fluids during the procedure. You will be given a medication through your IV to relax you and make you drowsy, but it will not put you to sleep. The nurse will connect you to several monitors. The monitors allow the doctor and nurse to check your heart rhythm, blood pressure and other measurements during the pacemaker implantation. Your left or right side of your chest will be shaved and cleansed with a special soap. Sterile drapes are used to cover you from your neck to your feet. A strap will be placed across your waist and arms to prevent your hands from coming in contact with the sterile field.

The doctor will numb your skin by injecting a local numbing medication. You will feel a pinching or burning feeling at first. Then, it will become numb. Once this occurs, an incision will be made to insert the pacemaker and leads. You may feel a pulling as the doctor makes a pocket in the tissue under your skin for the pacemaker. You should not feel pain. If you do, tell your nurse. After the pocket is made, the doctor will insert the leads into a vein and guide them into position using the fluoroscopy machine. After the leads are in place, their function is tested to make sure they can increase your heart rate.

Length of Time: The pacemaker implant takes about two to five hours including preparation and procedure.

After the Procedure: You will be admitted to the hospital overnight. The nurses will monitor your heart rate and rhythm. The morning after your implant, you will have a chest x-ray to ensure the leads and pacemaker are in the proper position.

Wound care: An occlusive dressing will be applied while you are in the hospital, which is not to be removed until your follow-up appointment in one week. You may not shower, drive, or lift anything until evaluated at your follow-up visit. You are not to lift your arm (side the pacemaker was inserted) above shoulder level. A sling will be provided.

Call your doctor if you notice:

* Redness (not pink, which is normal)

* Hardening of the skin around the incision

* Swelling or puffiness at the incision site

* Any Drainage; such as clear, yellow, or greenish or bright red bleeding coming

from the incision

*The incision area is not staying closed

*Fever/Chills

 

Pacemaker Identification: Your pacemaker settings will be checked before you leave the hospital. You will be given information about the type of pacemaker and leads you have, the date of implant, the doctor who implanted them.

In about three months you will receive a permanent card from the company. It is important that you carry this card at all times in case you need medical attention.

You will need to have a pacemaker check performed at least every 6 months to make sure the pacemaker is working properly and is set at the proper settings for you.

Preparation: Ask your doctor what medications you are allowed to take. Your doctor may ask you to stop certain medications one to five days before your test. If you are diabetic, ask your doctor how you should adjust your diabetic medications. Do not eat or drink anything after midnight the evening before your test.

Location: Pacemaker implantation is a hospital-based procedure.

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