A pacemaker is a small, lightweight, electronic device that is inserted into the body. It is prescribed for people whose hearts are beating too slowly. The pacemaker delivers electrical impulses that stimulate the heart and keep it beating at the proper rate. A pacemaker keeps track of the heart's electrical activity through "sensing". It also sends electrical impulses to make the heart beat called "pacing".
A pacemaker is made up of two parts: a pulse generator and either one or two leads. The pulse generator has a small metal case with a battery and circuitry. The battery supplies the energy to the circuitry that produces tiny electrical impulses at a controlled rate to the heart. A lead is a wire that is insulated and flexible. It is placed in the heart to carry energy from the pacemaker to the heart. One or two leads may be used depending on the type of pacemaker implanted.
Implanting a pacemaker is a minor surgical procedure that is usually done under local anesthesia.
If you are not in the hospital, you will be asked to arrive early in the morning on the day of the procedure, or possibly the night before. Several tests will be done, such as an ECG and blood tests.
The doctor or nurse will discuss the purpose of the procedure with you, including its benefits and risks. Be sure to ask questions and share your concerns at this time. You will then be asked to sign a consent form.
An intravenous (IV) line will be inserted into your arm. This line will be used to inject drugs into your vein, if needed. You will be given a sedative to help you relax. A local anesthetic is injected in the upper chest to numb the area where the pacemaker will be inserted. An incision is made below the collarbone and a pocket is made under the skin to house the pulse generator.
The lead is inserted through the chest incision and into a vein. Each of the leads is then connected to the pulse generator. The pulse generator is set and then tested to make sure it is working correctly. The incision is then closed and covered with a sterile dressing.
The procedure usually takes one to two hours.
Implanting a pacemaker is a simple procedure with little risk. However, as with any surgery, problems can occur such as bleeding, local swelling or a bruise.
In rare cases, there may be more serious complications, including lung puncture, heart damage, blood vessel damage, blood clots and infection. Deaths are very rare.
You will be taken to a recovery room after the pacemaker is implanted. It is normal to have some pain and stiffness around the incision for a few days. Your doctor may prescribe pain medication. Do not raise the arm on the side of the incision above shoulder level.
After a few days, you will probably to able to go back to most of your daily activities. It may take a few weeks before the incision is completely healed. You will have follow-up visits to the doctor's office or clinic to help ensure the pacemaker is working properly.
Call your doctor or nurse if:
Carry your pacemaker identification card with you at all times.