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.

GETTING READY:

The Week Before Your Pacemaker Procedure:

• Talk about your medicines and allergies with your caregiver:
  
  
  • Tell your caregiver if you have bleeding problems. If you take medicine to thin your blood, you may be asked to stop taking it before your pacemaker procedure. Ask your caregiver before you stop taking this or any other medicine. Tell your caregiver about any other medicines you are taking. This includes prescription medicine, over-the-counter medicine, herbs, and vitamins.
    
    
  • If you are diabetic or have blood sugar problems, ask your caregiver for special instructions. Your caregiver may want to change your diet and medicine before and after your pacemaker procedure.
  
  
• Go for tests:
  
  
  • You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.
    
    
  
  
• Arrange for family support: Have a family member or friend take you to the hospital and take you home. Have an adult stay with you for at least 24 hours after your pacemaker procedure.

The Night Before Your Pacemaker Procedure:

• Ask caregivers about directions for eating and drinking.
  
  

The Day Of Your Pacemaker Procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask caregivers before taking your medicines today. Ask a caregiver before taking any medicines on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Wear your glasses, dentures, or hearing aids. Do not wear contact lenses the day of your procedure. You may wear glasses. If you wear dentures or hearing aids, wear them to the hospital. Depending on the kind of anesthesia you have, you may need to remove your dentures and hearing aid before the pacemaker procedure. Your caregiver will let you know.
  
  
• Bring personal belongings. If you are staying in the hospital overnight, bring your personal belongings with you (bathrobe, toothbrush, hairbrush, slippers). Do not wear jewelry or bring money to the hospital.
  
  
• Take a bath or shower the night before your pacemaker procedure. Bathe and wash your hair before your pacemaker procedure. You may not be able to fully bathe for a week after your pacemaker procedure.
  
  
• Make sure you have an informed consent. You or someone you give permission to may be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the pacemaker procedure. Make sure all your questions have been answered before you sign the form.

TREATMENT:

What Will Happen:

• You will be asked to change into a hospital gown. An IV will be placed by your caregiver. You may be given medicine in your IV to help you relax or make you sleepy. Depending on what you and your caregiver agree on, you may be put to sleep or will remain awake but drowsy. You may also get a medicine called local anesthesia (an-iss-thee-ZUH). This medicine will numb your chest and neck, but you may still feel pressure. You will not remember much before or during your procedure.
  
  
• Caregivers will clean your neck and chest with a special soap. Sheets will be put over you to keep the procedure area clean. A lead is put into your vein in your neck or chest. The lead is guided into your heart using a special x-ray. The leads may be hooked to the inside or outside of your heart. The other end of each lead is connected to the generator.
  
  
• If you are receiving a permanent pacemaker, a pocket will be made under the skin just below your collarbone. The generator will be placed in this pocket. If you need a transvenous pacemaker, the leads are hooked to your heart and then attached to the generator. With a transvenous pacemaker, the generator is left outside your body. The generator will be put in a pouch that you carry with you everywhere. The incision in your neck or chest is closed with stitches. The incision just below the collarbone is also closed with stitches. The procedure may last 1 to 2 hours.

What will happen after my 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 after you are awake and your pain is controlled. If your are going home, you will be allowed to leave as soon as you are awake and your pain is controlled.

Waiting Room: This is a room where your family can wait until you are ready for visitors after the pacemaker procedure. This is a place where your caregivers can find family to tell them how your procedure went. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

CONTACT A CAREGIVER IF:

• You cannot make it to your procedure appointment on time.
  
  
• You have questions or concerns about your procedure or the pacemaker.
  
  
• You have a fever (increased body temperature).
  
  
• The problems for which you are getting the pacemaker become worse.

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.

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