Pacemaker

WHAT YOU SHOULD KNOW:

• A pacemaker is a small device that helps regulate your heart rate. A pacemaker is about the size of a wristwatch. When your heart beats too slow causing dizziness, your caregiver may want you to have a pacemaker. The pacemaker will make your heart beat at a faster rate so that you no longer feel dizzy. If you have arrhythmias which cause your heart to beat too fast, a pacemaker can slow it down.
  
  
• A pacemaker is made up of leads (thin, flexible wires) and a generator (JEN-uh-ra-tor). Most pacemakers work only when they are needed. These are called demand pacemakers. Other pacemakers work all the time. Your caregiver will decide which pacemaker is right for you.
  
  
• You will need a procedure to get a pacemaker unless you have a transcutaneous pacemaker. This procedure may be done while you are already a patient in the hospital. You may also come into the hospital in the morning and go home after your procedure. You may also need to stay in the hospital for a time.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• There are always risks involved with this type of procedure. You may bleed more than usual or get blood clots. Blood clots can lead to a stroke. Infection in your heart may occur. If this occurs, your pacemaker will need to be removed. A new pacemaker will need to be placed, but only after you are treated with antibiotics (an-ti-bi-AH-tiks). Putting leads into your heart may cause arrhythmias. The leads could also poke a hole in your lung, heart, or vein. Blood may form in the pocket where the generator is placed. This can cause pain and infection.
  
  
• If you do not get a pacemaker, your heart problems could get worse and you could die. Ask your caregiver if you have any questions about your care.

WHILE YOU ARE HERE:

Before Your Pacemaker Procedure:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Call button: You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before taking off your oxygen. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.
  
  
• Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.
  
  
• Heart monitor: This is also called an ECG. Sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This shows caregivers a tracing of the electrical activity of your heart.
  
  
• Bathroom: Go to the bathroom before your pacemaker procedure. Otherwise, you may have to wait until after the procedure.
  
  
• Transport: You will be taken on a cart to a special procedure room. A caregiver will help you onto a special table and will help make you comfortable. A belt will be put over your legs for safety. Your arms will be tucked at your sides. The room will be very bright and noisy, and there will be lots of people walking around.
  
  
• Medicines: You will be given medicine in your IV to make you sleepy and relaxed.
  
  
  • Anesthesia: Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment. An adult may need to drive you home and stay with you after you have had anesthesia.
    
    
  • Local or monitored anesthesia: This is a shot of numbing medicine put into the skin where you will have surgery. You may still feel pressure or pushing during surgery but you should not have pain. With local anesthesia, you will be fully awake during the procedure. With monitored anesthesia care, you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the procedure.

During Your Pacemaker Procedure:

• Your caregiver will clean your neck and chest with a special soap. This soap may make your skin yellow, but it will be cleaned off later. Sheets will be put over you to keep the procedure area clean. Leads are put into a vein in your neck or chest. With the help of a special x-ray, the leads are guided into your heart. The leads will either be sewn to the inside or outside of your heart. The other end of each lead is attached to the generator.
  
  
• If you are having a permanent pacemaker placed, an incision is made just below your collarbone. A pocket is made under your skin where the generator will be placed. If you are having a temporary pacemaker placed, the generator is left outside your body. You will need to carry it with you in a small pouch. Your pacemaker will be set according to what is right for your heart. The procedure may last 1 to 2 hours.

After Your Pacemaker Procedure: You will be taken to a recovery room where you will wake up. There will be lots of noise and activity. This is normal. Caregivers will be checking on you often. You will have a bandage covering your stitches. If you are staying in the hospital, you will be taken to your room when you are awake and your pain is controlled. If you are going home, you will be allowed to leave as soon as you are awake and your pain is controlled.

What Medicines Will I Take After My Pacemaker Procedure?

• Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up). Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time.
  
  
• Heart medicine: This medicine may be given to make your heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with your caregiver to find out what your medicine is and why you are taking it.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Link to Page

Print Page

Email Page