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Pacemaker

AMBULATORY CARE:

A pacemaker

is a small device placed in your chest. It helps control your heartbeat. You may need a pacemaker if your heartbeat is too slow, too fast, or irregular. A pacemaker is about the size of a large wristwatch. It is made up of flexible wires (leads) with sensors, a battery, pulse generator, and a small computer. The sensors measure your heartbeat. They send this information to the computer. The computer causes the generator to send electrical impulses to your heart. This makes your heart beat correctly. Some pacemakers can also record your heart rate and rhythm.


How to prepare for a pacemaker insertion:

Your healthcare provider will talk to you about how to prepare for the procedure. You may need a blood test, chest x-ray, or other tests before your procedure. These tests will help your provider plan your procedure. Your healthcare provider may tell you not to eat or drink anything after midnight on the day of your procedure. He or she will tell you what medicines to take or not take on the day of your procedure. You may be given an antibiotic to prevent infection. Tell a healthcare provider if you have ever had an allergic reaction to an antibiotic.

What will happen during a pacemaker insertion:

  • You may be given IV sedation to make you feel calm and relaxed during the procedure. You may also be given local anesthesia to numb the procedure area. With local anesthesia, you may still feel pressure or pushing, but you should not feel any pain.
  • Your healthcare provider will insert a needle into a large vein in your chest or neck. Next, he or she will guide the wires through the needle and into your heart. Your healthcare provider will make an incision in your chest and insert the pacemaker. He or she will connect the wires in your heart to the pacemaker. He or she will also make sure the pacemaker is working correctly. Your incisions will be closed with stitches, medical glue, or Steri-strips™. They will be covered with a bandage.

What will happen after a pacemaker insertion:

Healthcare providers will monitor your heartbeat. You may need a chest x-ray and an EKG. These tests will make sure your pacemaker is in the correct position and working correctly. You may have bruising or pain near your incision. This should get better in a few days. You may need to spend a night in the hospital.

Risks of a pacemaker insertion:

You may bleed more than expected or get an infection. The pacemaker could move out of place and cause pain and bleeding. The leads may cause a hole in your lung, heart, or blood vessel. Your pacemaker may stop working correctly. This can cause an irregular heartbeat, heart failure, blood clots, or other problems. These problems may become life-threatening.

Call 911 for any of the following:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • and any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You feel weak, dizzy, or faint.
  • Your stitches come apart.
  • Your pulse is lower or higher than your healthcare provider said it should be.

Contact your healthcare provider if:

  • You have a fever or chills.
  • Your wound is red, swollen, or draining pus.
  • You have questions or concerns about your condition or care.

Care for your incision as directed:

Ask your healthcare provider when you can remove your bandage. Wash around your incision with soap and water. It is okay to let soap and water run over your incision. Do not scrub your incision. Gently pat the area dry, and apply new, clean bandages as directed. Check your incision every day for redness, swelling, or pus.

Activity:

  • Do not lift anything heavier than 3 pounds with the arm closest to your pacemaker. Do not lift the arm over your head until your healthcare provider says it is okay. Ask your healthcare provider how long to follow these instructions.
  • Do not do vigorous activities. This includes contact sports and some types of exercise. These activities can damage your pacemaker or cause your wires to move. Ask your healthcare provider what activities are safe for you to do.

Pacemaker safety:

  • Tell all healthcare providers that you have a pacemaker. MRI machines and certain equipment used during surgery can affect how your pacemaker works.
  • Limit or avoid close contact with certain electrical devices. Examples include cell phones, iPods™, microwave ovens, and generators. These devices can prevent your pacemaker from working correctly. Stand at least 2 feet from a generator. Do not put your cell phone or iPod in the chest pocket closest to your pacemaker. Use the arm opposite your pacemaker to hold and use your cell phone.
  • Tell airport security that you have a pacemaker before you go through the metal detectors. Metal detectors may beep because of the metal in your pacemaker. Step away from the machine if you feel dizzy or your heart rate increases. Ask the security agents not to hold a security wand over your pacemaker for more than a few seconds. Your pacemaker function or programming may be affected by the wand.
  • Wear medical alert identification. Wear medical alert jewelry or carry a card that says you have a pacemaker. Ask your healthcare provider where to get these items.
    Medical alert ID bracelet
  • Check your pulse as directed. Check for 1 minute while you are resting. Write down your heart rate. Bring a copy of these numbers to your follow-up visits.

What you need to know about care of your pacemaker:

  • Your healthcare provider will check your pacemaker about every 3 months. Some checks may be done over the telephone. He or she will make sure it is working correctly. You may also need regular EKGs to check the electrical activity of your heart.
  • Your pacemaker generator, battery, and leads will need to be replaced. The battery may need to be replaced in 6 to 7 years or longer. The generator will be replaced at the same time. The battery and generator are replaced during surgery. Your leads will need to be replaced if they cause an infection or move out of place. Your healthcare provider will monitor you and decide when these parts need to be replaced.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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