Pacemaker Implantation

A pacemaker (pacer) is a small device that acts as a backup or takes over for the natural pacemaker of the heart. The heart has its own electrical system to regulate the beating of the heart muscles. The heart pumps best when it beats in a regular, coordinated rhythm.

A pacer consists of a small device (generator) which produces electrical signals that tell your heart to beat. The generator contains a lithium battery and a tiny computer. Wires (leads) connect the generator to the heart. The pacer is placed under the skin through a small cut. It senses every heartbeat and only fires when the heart rate falls outside certain levels. When the pacer triggers a heart beat, it is called "capture."

PROBLEMS THAT MAY BE HELPED BY A PACEMAKER:

  • Your heart rate is sometimes too slow or irregular.

  • Fainting, dizziness, weakness or confusion as a result of low blood flow.

  • Shortness of breath.

  • Chest pain or angina if the heart needs more blood and oxygen.

  • Disturbed sleep as a result of abnormal heart rhythm.

  • Palpitations or the feeling that the heart is beating too fast, too hard or in an irregular way.

  • Weak heart muscle pumping ability.

PROCEDURE

  • The pacer may be placed under the skin near the collarbone, while you are under sedation. An abdominal wall location may be another option.

  • The leads are inserted into a vein that lies just under the collarbone, then guided into place under x-ray. The tips of the wires touch the inside of the heart. The near end of the pacer wires are connected to the generator under the skin.

  • For individuals with thinner chest walls, it may be possible to feel the device under the skin, and a slight bump may be seen.

HOME CARE INSTRUCTIONS

  • Keep the incision dry for a week after the procedure.

  • For about 8 weeks, avoid sudden or jerky movements that pull your arm away from your body. This could change the position of the leads.

  • Take medicine exactly as directed.

  • Learn how to check your pulse. Follow directions about when to call or be concerned.

  • Be physically active every day. Ask your caregiver how and when to increase activity.

  • Household appliances do not interfere with pacemakers.

  • Travel by car, train or airplane should not be a problem. Carry a pacemaker ID card in case the device sets off a metal detector.

PACEMAKER CARE:

  • Avoid putting pressure over the area where the pacer was put in.

  • Digital cell phones should be kept 12 inches away from the pacemaker. Hold them at the ear on the side opposite of the pacer.

  • Never leave a cell phone in a pocket over the pacemaker.

  • Avoid strong electro-magnetic fields. You will not be able to have an MRI scan because of the strong magnets.

  • Pacer batteries last about 5 years and give off warning signals when they are running low on power. Pacers may be checked every 3 months. This allows plenty of time to change the generator when it is running low on power.

  • Changing the battery means removing the old generator through the same cut and plugging the existing wires into the new generator.

  • An EKG or heart monitor is used to see if your pacer is working properly. Sometimes signals may be sent over a land line phone to your clinic.

  • Tell emergency responders that you have a pacemaker.

SEEK MEDICAL CARE IF:

  • You begin to gain weight and your feet and ankles swell.

  • You have dizzy spells or feel weak.

  • Your pulse rate drops below the limit or is too fast.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You faint or pass out.

  • You have chest pain or shortness of breath.

  • You are injured and think your pacemaker may have been damaged.

  • You are suddenly very tired or have pain in your back.

  • You are worried that your heart is not beating right or cannot feel your pulse.