Permanent Pacemaker

A pacemaker is implanted in the catheterization laboratory. The patient is given sedation through an intravenous line as well as a local anesthetic to the chest wall. A small incision is made and a generator is implanted. There are one to two wires that will be threaded through a vein into the right side of the heart. The generator and wires will be connected and the incision will be closed with sutures/staples. The device will be tested prior to leaving the room. A dressing will be applied and the patient is taken to the holding room where a chest x-ray will be obtained. The patient will spend the night in the hospital to be monitored overnight. The procedure will take about an hour.

Why you are having this procedure (symptoms/indications):

If your heart rate is too slow or if you are having episodes of fainting and your doctor informs you it is because your heart rate is causing you to pass out. Some patients may get a pacemaker because of tachy-brady syndrome, which is when your heart beats too fast, such as with atrial fibrillation and the medications you are given cause your heart to go too slow.

Prep for the procedure:

Nothing to eat or drink after midnight. Inform the nursing staff of all of your allergies as well as your routine medications.

Risks:

Infection, bleeding, pneumothorax (collapsed lung), swelling at sight, bruising, reaction to medication given for sedation, and blood vessel or nerve damage, perforation of wall of heart that could result in tamponade, and rare death.

Post procedure instructions/limitations:

You will wear a sling and need to wear this for three to four weeks. It is important not to lift your arm above shoulder height. It is best to take sponge baths for the first couple weeks so the dressing will remain dry. No driving for three to four weeks. Resume your medications as your cardiologist instructs. The patient will not have to perform any dressing changes.

When to call your cardiologist:

Bleeding from the incision, shortness of breath, severe pain at the pacemaker site, frequent hiccups or twitching of your abdominal muscles, and dizziness or passing out episodes.

Miscellaneous:

If you ever feel your heart racing you will be able to download your pacemaker and your cardiologist will be able to review the data and help determine if you are having any irregular rhythms. The battery will usually last around five years but this is dependent upon how much your heart needs pacing.

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