A pacemaker has two parts:

• a pulse generator, which is the battery/timer unit
• one or more electrodes and wires that carry the electrical impulses to the heart

Why do I need a pacemaker?

The purpose of a pacemaker is to assist your heart contracting and pumping blood in a regular rhythm.  You may have very slow heartbeats or both slow and fast heartbeats if there is an electrical problem in any of the heart’s cells.  Dizziness, fainting spells, and shortness of breath may be symptoms of a heart rhythm disturbance. 

What is the implant procedure?

Having a routine pacemaker implant is not considered major surgery.  The procedure generally is performed under local anesthesia with the patient sedated, but awake.  The surgeon makes an incision in the upper chest area and a small pocket is made under the skin over a vein.  The pacemaker will rest in this pocket. 

As the physician watches progress on a monitor, the wires are guided through a vein into the heart’s chambers.  At one end of a wire the electrode rests directly against the inner wall of the heart.  The other end of the wire is attached to the battery/timer that is placed in the pocket under the skin.

What are the risks?

As with any operation, possible complications include bleeding problems or infections.  Problems specific to pacemaker implants include the possibility of a lead becoming dislodged after surgery and pacemaker malfunction.  Please talk with your doctor about potential risks.

How will I feel with my new pacemaker?

Your heartbeat should be more reliable after the pacemaker is inserted.  Symptoms you experienced prior to your pacemaker implant should go away or be improved.  Your pacemaker may require some fine tuning, and medications may be adjusted, but chances are you may feel a lot better.

What should I do when I get home?

Your doctor or nurse can instruct you how to care for the incision and when to have your stitches removed.  Strips of tape may be placed over the incision instead of stitches.  Antibiotics may be prescribed to reduce the occurrence of infection after pacemaker surgery.

It takes a few weeks for pacemaker wires to become secure.  During that time avoid activities such as driving, hard arm exercises or lifting weights.  Slow arm circle exercises may be recommended to alleviate soreness. Ask your doctor about activities to avoid.

When may I return to my regular activities?

Follow your doctor’s advice regarding the activities you may return to within a few weeks without fear of causing problems with the pacemaker.  Avoid pressure on the pacemaker site and any contact sport that could result in the pacemaker being hit or crushed.  Ask your doctor about specific activities. 

What about electrical interference?

Currently available pacemakers are insulated to help protect them from many home shop tools and electrical appliances, including microwave ovens and cell phones.  However, power-generating equipment and powerful magnets are capable of inhibiting a pacemaker’s function.  Check your pacemaker manufacturer’s guide regarding sources of electrical interference. 

Be aware of your surroundings and the devices that may interfere with your pacemaker.

How does a pacemaker work?

A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly.  An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart.  The pacemaker senses your own heartbeats.  It turns itself off when the heartbeat is above a certain level and turns back on when the heartbeat is too slow.

Many pacemakers may be programmed.  This means the doctor can adjust the pacemaker from outside the body, without surgery.  The life span of a pacemaker will depend on how much it is being used and how much energy is required to pace the heart.   Your doctor can advise you how often to check your pacemaker.

This information is provided as a general overview of pacemakers.  The decision to undergo pacemaker surgery is an important decision that you and your doctor will make together. 

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