Pacemaker
What is a pacemaker?
A pacemaker prevents the heart from beating to slowly by delivering a pacing stimulus to the heart to keep a patient’s heart rate above a determined number of beats per minute. We often program a patient’s pacemaker to keep the patient’s heart at or above 60 beats per minute. While pacemakers can prevent the heart from beating too slowly, a pacemaker cannot prevent the heart from beating too rapidly.
The pacemaker is placed under the skin, generally on the left side of the chest. The pacemaker is connected to one, two, or three leads depending upon the needs of the patient. These leads travel from the pacemaker under the skin, into a vein and then down to the heart to the inside of the heart. The leads stay connected to the heart by tiny screws at the tip of the leads that hold them to the muscle of the heart. These leads send information about every beat of the heart back to the pacemaker in the shoulder. The pacemaker then knows whether to pace the heart.
How is a pacemaker implanted?
Pacemaker implantation procedures are performed in the electrophysiology laboratory in the hospital. First, the patient changes into a hospital gown and IV lines are started. The patient is the given sedation through an IV in the arm. The procedure begins with the administration of local anesthesia in the area where the defibrillator is being placed. After the area is anesthesized, a 4 cm incision is made and the leads and the pacemaker are placed in position. This process may take anywhere from one to several hours depending upon how many leads are being placed in the heart.
What is the recovery following the procedure?
Patients are observed overnight in the hospital and are generally discharged to home the next day. There is usually a modest amount of pain in the shoulder area for one to two weeks following the procedure. Patients are sent home with a prescription for pain medicine although most patients do not require it.
What is the follow-up?
After discharge from the hospital, patients are scheduled to return to the Heart Center one week after the procedure so we can inspect the incision. The patient is seen every three months in our office so we can check the pacemaker.
What are the restrictions following the procedure?
The patient is instructed to keep the arm on the side of their pacemaker below the level of the shoulder for 6 weeks following the procedure and to avoid lifting anything more than 10 lbs with that are for the first 3 months. After the first three months, patients are instructed to avoid lifting anything more than 30 lbs with that arm.
How is a pacemaker different from a defibrillator?
A pacemaker prevents slow heart rhythms by pacing the heart if it begins to slow down. A defibrillator can do this as well. A defibrillator has the added capability of treating fast heart rhythms. Only those patients who are at high risk of life threatening fast heart rhythms are offered a defibrillator instead of a pacemaker. Your cardiologist will help determine which device is best for you.
Can I travel?
Once the incision is fully healed, it is usually safe for patients to travel. However, patients are encouraged to touch base with their cardiologist before making plans for long-distance traveling.
With regard to passing through airports, we ask patients to present their pacemaker card to the airport security. This card will be given to you after your pacemaker is implanted. It will be important for the airport security to know that you have a pacemaker. Patients may walk through the security booths but we ask that the security wand not be placed over the pacemaker.
Can I use a microwave?
It is perfectly safe for patients with a pacemaker to use a microwave.
Can I use a cellphone?
Yes, we simply ask that you hold the cellphone to the ear on the side opposite of your pacemaker. We also ask that you do not place the cellphone in a pocket immediately over the pacemaker.