A pacemaker is a small electronic device that helps regulate slow electrical problems in the heart. The pacemaker is usually implanted in the chest, just below the collarbone. Your doctor may recommend this device to keep your heartbeat from slowing down to a dangerously low rate.
The heart is a pump made up of muscle tissue that is stimulated by electrical currents, which normally follow a specific circuit within the heart. These natural electrical impulses coordinate contractions of the different parts of the heart to keep blood flowing the way it should. A pacemaker may be needed when there are problems with the natural electrical conduction system of the heart.
A pacemaker is made of 3 parts: a pulse generator, 1 or more leads, and an electrode on each lead. A pacemaker signals the heart to beat when the natural heartbeat is too slow or irregular.
Your doctor may recommend a pacemaker to stimulate a faster heart rate when your heart beats too slow and the problem can't be fixed with other treatments.
Problems with the heart rhythm may mean your heart is not pumping enough blood to the body. If your heart rate is too slow, the blood is pumped too slowly. If the heart rate is too fast or too irregular, the heart chambers are unable to fill up with enough blood to pump out with each beat. When the body does not get enough blood, symptoms such as tiredness, dizziness, fainting, or chest pain may occur.
Some examples of heart rate and rhythm problems for which a pacemaker might be inserted include:
There may be other reasons for your healthcare provider to recommend pacemaker insertion.
Possible risks of pacemaker insertion include:
For some people, having to lie still on the procedure table for the length of the procedure may cause some discomfort or pain.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
A pacemaker insertion may be done on an outpatient basis or as part of your hospital stay. Procedures may vary depending on your condition and your healthcare providers practice.
Generally, a pacemaker insertion follows this process:
After the procedure, you may be taken to the recovery room for observation or returned to your hospital room. A nurse will monitor your vital signs.
Let your nurse know right away if you feel any chest pain or tightness, or any other pain at the insertion site.
After the period of bed rest has been completed, you may get out of bed with help. The nurse will be with you the first time you get up, and will check your blood pressure while you are lying in bed, sitting, and standing. Move slowly when getting up from the bed to avoid any dizziness.
You will be able to eat or drink once you are completely awake.
The insertion site may be sore or painful. Pain medicine may be taken if needed.Your arm may be placed in a sling overnight. Your provider will give you specific instructions on any activity restrictions and about immobilizing your arm after the procedure.You will have a chest X-ray to make sure the lung was not injured during the procedure, and to check the device position.You may be prescribed antibiotics to protect you from an infection around your pacemaker or at the incision site.
Your healthcare provider will see you in your room while you are recovering. The healthcare provider will give you specific instructions and answer any questions you may have.
Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or allowed to go home. It’s common to spend at least one night in the hospital after pacemaker implantation.
Arrange to have someone drive you home from the hospital following your procedure.
You should be able to return to your normal daily routine within a few days. Your healthcare provider will tell you if you will need to wait before returning to your normal activities. Do not do any lifting or pulling for a few weeks. You may need to limit movement of the arm on the side that the pacemaker was placed.
You will most likely be able to go back to your usual diet, unless your healthcare provider tells you differently.
It will be important to keep the insertion site clean and dry. You will be given instructions about bathing and showering.
Your healthcare provider will give you specific instructions about driving.
Ask your healthcare provider when you will be able to return to work. The nature of your work, your overall health, and your progress after surgery will determine how soon you may go back to work.Call 911 if you have severe, unrelenting chest pain or trouble breathing.
Contact your healthcare provider right away if you have any of the following:
After a pacemaker insertion, regularly scheduled appointments will be made to ensure the pacemaker is working the way it should. The healthcare provider uses a special computer, called a programmer, to review the pacemaker's activity and adjust the settings when needed.
Your healthcare provider may give you other instructions after the procedure, depending on your particular situation.
Always consider the following precautions. Discuss these in detail with your healthcare provider, or call the company that made your device:
Before you agree to the test or the procedure make sure you know:
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