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Pacemaker Tutorial

When an arrhythmia, or irregular heartbeat, can not be fixed with medication, a pacemaker is used to regulate the beating of the heart. A pacemaker is a small box consisting of a battery, microchip and either 1 or 2 wires. The wires, called leads, are used to monitor the heart muscle. The leads send information about the heart's rhythm back to the microchip. If the heart is beating irregularly, the microchip tells the battery in the pacemaker to send electricity down the leads and into the heart muscle to make it beat.

  1. Implantation

    • A pacemaker takes about 1 hour to implant, and the procedure can sometimes be done on an outpatient basis, although staying in the hospital overnight is very common. Before the operation, your doctor may have you stop taking certain medications such as aspirin and other blood thinners. Your doctor will also ask you to avoid eating and drinking for several hours prior to surgery. When it is time for surgery, your doctor will give you a local anesthetic to numb you. She will then make a 2 or 3-inch cut under your collarbone. With the help of a special X-ray, the lead wires of the pacemaker will be threaded through this incision and attached to your heart muscle. A pocket will be made under your skin to hold the box part of the pacemaker. The leads will be attached to the box and your incision will be closed.

    Post-Operative Care

    • Immediately after your pacemaker is implanted, your pulse and blood pressure will be closely monitored by the hospital staff for a few hours. You will not be allowed to drive yourself home when you are discharged from the hospital, so plan ahead to make sure you have a ride. The incision site may be sore for a few days after your pacemaker is implanted, but this a usually be resolved with over-the-counter medications. A soft pad placed over the incision may help to cushion it from irritation caused by bra straps. For 4 to 6 weeks after surgery, it is important to avoid strenuous activity and lifting anything that weighs more than 10 pounds. Be sure to observe all of the discharge instructions given to you by your doctor.

    Life With a Pacemaker

    • Your pacemaker should be checked twice a year for proper operation. Your doctor can check and regulate your pacemaker in his office by using a wand that emits radio signals or over the telephone with a device called a trans-telephonic monitor. You may also check your pulse rate periodically to make sure it is where your doctor wants it to be. People with a a pacemaker should avoid exposure to magnets such as those found in MRI machines and should not put a cell phone in a shirt pocket directly over the pacemaker. The Patient Education Institute reports that MP3 players and similar devices have been shown to affect the performance of pacemakers and should be avoided. A direct heavy blow, such as the recoil of a shotgun, could damage the pacemaker and should be avoided. The battery in your pacemaker will need to be replaced via an outpatient procedure about once every 6 years.

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