A pacemaker is a small electronic device that
helps the heart to beat at a proper rate. It keeps track of your
normal heart beat, and can sense when it becomes too slow. When
that happens, the pacemaker generates a small electrical impulse,
very similar to the heart's natural impulse. This keeps your heart
beating at a normal pace.
Your pacemaker has two main parts: the generator
and the lead(s). The generator is a
small, flat, lightweight metal case that contains a tiny computer
and battery. This is the part that generates the electrical impulses.
The leads are wires covered by soft, flexible plastic. Working
together to regulate your heart, they monitor how well the heart
is beating and will send electrical impulses from the generator
to the heart when it senses it is necessary.
Prior to your procedure, your physician may
request tests, such as an electrocardiogram (ECG) and blood tests.
They will review all medications you are taking, and give you
any special instructions concerning them. You'll be told where
and when to report for your pacemaker (unless you're in the hospital)
and what to do before you arrive. Generally, you'll be asked not
to eat or drink anything after midnight the evening before your
procedure (except sips of water to swallow your pills).
Just before your procedure, your cardiologist
or one of the cardiology nurses will discuss your pacemaker insertion
— its purpose, benefits, and potential risks. The insertion
of a pacemaker is a common, low-risk surgical procedure with a
very small risk of complications. These might include puncture
of the heart or lung tissue, damage to the vein, infection, bleeding,
and/or bruising. Although the rate of complications is very low,
you'll be asked to sign a routine consent form. This is a good
time to ask questions or talk about any concerns you may have.
Before your procedure, an intravenous line
(IV) will be inserted in your arm to administer any medications.
The area where the pacemaker will be inserted will be washed with
an antiseptic soap and shaved. You will be taken to a special
procedure room where you'll be covered with sterile drapes. You'll
be awake through the procedure, but will be given a sedative to
help you relax.
The procedure room personnel, who have been
trained specifically in the electrical activity of the heart,
will be wearing surgical hats and masks to assure that the environment
is kept as clean as possible. Your ECG, heart rate, blood pressure,
and oxygen level will be monitored throughout the procedure.
A local anesthetic will be injected under
the skin to numb the site where the pacemaker will be implanted
in the upper part of the chest. Then the cardiologist will make
a small incision, and form a "pocket" under the skin to hold the
generator. The leads will be inserted into a vein under the collarbone
and guided into your heart using an x-ray monitor, and tested
periodically to determine their best positioning. After the leads
are in place, they will be attached to the generator, which will
then be gently placed into the skin "pocket". Then the incision
will be closed with dissolvable stitches and a small bandage applied.
During the procedure you may feel some pushing
and tugging on your skin. However, you should feel very little,
if any, discomfort overall. The procedure usually lasts approximately
one and one-half hours.
Your Recovery
After the procedure, you'll be taken to a
hospital room or a recovery area. It's very likely you'll be kept
overnight in the hospital so your heart can be monitored to make
sure your pacemaker is functioning well. You'll be asked to limit
the use of your arm on the side the pacemaker was inserted to
give the leads an opportunity to heal to your heart tissue.
You may feel some discomfort in the incision
area when the local anesthetic wears off. If so, the staff will
give you some medication to make you more comfortable. Be sure
to tell your nurse if you experience any unusual symptoms such
as hiccups, dizziness, or chest pain.
Before you leave the hospital, you'll be given
detailed instructions about caring for your incision site. You'll
also be told what signs and symptoms to report, and you'll be
given a follow-up plan. You should arrange ahead of time for someone
to drive you home.
Your Good Health
Your pacemaker will help make sure your heartbeat
remains strong and regular, but you also play an important role
in staying healthy. Be sure you understand your follow-up plan
and keep all appointments for exams and follow-up tests. Follow
your instructions, don't hesitate to talk about your concerns,
and immediately report any new symptoms.
As always, if you have any questions about
your health, be sure to ask your physician.
If you are a Munson Healthcare patient and have a compliment,
concern, or complaint, please contact one of our Patient
Liaisons.
