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.
  
  
• A pacemaker is made up of leads (thin, flexible wires) and a generator. 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. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. 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. 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: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• 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.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• 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: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
    
    
  • 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 to help prevent vomiting.
  
  
• Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

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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.

Learn more about Pacemaker (Inpatient Care)