What is a pacemaker?
A pacemaker is needed when problems occur with the electrical conduction system of the heart. This causes the timing within your heart’s pumping chambers to be altered so that your heart is beating too slowly or irregularly. A pacemaker can signal your heart to beat at a steadier rate.
A pacemaker is comprised of three parts: a pulse generator, one or more leads, and an electrode on each lead. The pulse generator is a small metal case that contains circuitry and a battery. It regulates the impulses sent to your heart. A lead is an insulated wire that is connected to the pulse generator on one end, while the other end is inside one of the heart’s chambers. The electrode on the end of a lead touches the heart wall, delivering electrical impulses to the heart. The electrode also sends information about the electrical activity in your heart back to the pulse generator.
What is a pacemaker insertion?
A pacemaker insertion is the implantation of a pacemaker (described above) into the chest just below the collarbone to help regulate electrical problems with the heart. You will be given a sedative and a local anesthetic at the insertion site prior to the procedure. Once the anesthetic has taken effect, the physician will make a small incision at the insertion site. A sheath or introducer is inserted into a blood vessel, usually under your collarbone. The introducer is a tube through which the pacemaker lead wire will be inserted and advanced to your heart.
Once the lead wire is in place, it will be tested to verify proper location and that it works. There may be one, two or even three wires inserted, depending on the type of pacemaker your physician has selected for your condition. Following testing, the pacemaker generator will be slipped under the skin through the incision after the leads have been attached to it. Generally, pacemakers are placed on your non dominant side—e.g., on your left if you are right-handed and vice versa. The incision will be closed with sutures, adhesive strips or special glue. A sterile bandage will be applied.
In the recovery room, a nurse will monitor your vital signs. If you feel any chest pain or tightness, tell the nurse immediately. After a period of rest and monitoring, you will be allowed to sit up and perhaps get out of bed. You may drink or eat once you are awake. Your physician will visit you during recovery. Once your blood pressure, pulse and breathing are stable, your physician will probably discharge you.
Why is your doctor requesting pacemaker insertion?
Some examples of heart rate and rhythm problems for which your doctor might suggest pacemaker insertion include:
- Bradycardia – the heart beats too slow
- Tachy-brady syndrome – alternating fast and slow heart beats
- Heart block – the electrical signal in your heard is delayed or blocked after leaving the heart’s sinoatrial (SA) node, the heart's master pacemaker
How do I prepare?
Do not eat or drink after midnight. Medicines prescribed by your doctor may be taken with sips of water.
How long will it take?
If the procedure is performed on an outpatient basis, you may be allowed to leave after you have completed the recovery process. The entire process from check in to discharge will take 2-4 hours. However, if there are concerns or problems, you may be admitted to the hospital for overnight observation.
- Always wear an ID card that states you have a pacemaker.
- Use caution when going through airports. Especially avoid hand-held detector devices, as these may affect your pacemaker.
- You should not have magnetic resonance imaging (MRI) procedures.
- Avoid large magnetic fields, such as power generation sites.
- Turn off large motors, such as cars or boats, when working on them.
- Cell phones in the U.S. with less than three watts of output do not seem to affect pacemakers; however, as a precaution, keep cell phones at least six inches from your pacemaker. Do not carry cell phones in a breast-pocket.
- Consult your physician if you feel ill after any activity or if you have any questions.