Heart Arrhythmia Devices & Implants

Pacemaker Implant

When the electrical system in your heart is not working properly, you may have:

  • Very slow heartbeats
  • Slow and fast heartbeats
  • Dizziness
  • Fainting spells
  • Shortness of breath

How is a pacemaker inserted?

We currently use two kinds of pacemakers. The first is placed through an incision under your collarbone on your chest. The wires or “leads” are placed in a vein inside your chest and attached to the pacemaker. There may be two or three leads, depending on your needs.

The second is a “leadless” pacemaker that is about the size of a vitamin capsule. This type of pacemaker is inserted through a vein in your groin, and moved via catheter up into your heart. 

With either pacemaker, the incision area will receive numbing medication. You also will receive an IV for medications to help you to relax and control any pain you may have. The procedure typically takes about 45 minutes. 

What happens after the pacemaker is inserted?

You will be taken to a room to be monitored until you are fully awake and your vital signs are stable. You may be discharged to go home the same day, or the physician may decide to keep you overnight.

What happens after I go home?

If you received the pacemaker with leads (the incision was made under your collarbone in your chest), you will go home with a sticky, waterproof dressing covering the incision area. You may shower with this, but don’t let the shower stream hit the dressing directly. We prefer you cover the dressing with plastic wrap to help keep it dry. The dressing will be removed during a follow-up visit to our office. At that time we check the incision site as well as the pacemaker's function. 

If you receive the “leadless” pacemaker (incision was made through your groin), the site is covered with a bandage. We ask that you keep it covered and dry until your follow-up visit. 

If needed, you can use ice and over-the-counter pain medications to help discomfort. 

What are my instructions or restrictions after the pacemaker?

First 30 Days:

  • For chest incision pacemaker – Please do not lift your left elbow higher than your shoulder for the first 30 days. This allows the wires to heal and stabilize. You will go home with a sling or shoulder immobilizer.
  • The sling does not have to be worn all day if you can remember to keep your arm down, but wear at nighttime for the full month. 

First 2 Weeks:

  • Do not lift more than 10 pounds for 2 weeks with any type of pacemaker 
  • You may drive after 1 week 

Exercises:

If you had a chest implant, the following exercises should be done to keep your shoulder joint mobile:  

  • Shoulder rolls and shrugs - Move your shoulder up and down, forward and backward 
  • Small arm circles - Lean forward, let your arm hang loosely, swing clockwise, then counterclockwise 
  • Walking arm up wall - Stand facing a wall with your feet apart. Slightly bend your elbow and place your fingers on the wall at shoulder level. “Walk” your fingers up the wall. It’s okay to go higher than your shoulder level with this exercise. 

Do these exercises 4 times a day, 6-7 repetitions of each exercise. 

Cautions:

Do not carry your cell phone in the shirt pocket over the device.

Microwaves, electric razors, Life Alert buttons, etc. are fine to use. It is best to call our office if you encounter other electrical items that may cause interference. If you take a blood thinner, or antiplatelet medication, bruising is normal while healing. This can go from the incision all the way down your abdomen. See bullet list below.

When do I need to call my doctor?

  • A fever over 100 degrees 
  • Redness, swelling or warmth at the incision site
  • Drainage from the incision site
  • Increased pain or nausea 

How long do pacemakers last?

A typical pacemaker lasts from 5-10 years on average. This depends on how much you use the pacemaker. When it is time to replace it, we will make an incision where the current device is and replace the pacemaker. The whole unit is replaced and attached to the leads you already have as long as they are working appropriately. You would go home the same day in these cases.