Treatment of Arrhythmia

Pacemaker Implantation

What is a pacemaker?
A pacemaker is a battery-powered device used to speed up dangerously slow heartbeats. A slow heartbeat can bring on weakness, shortness of breath, confusion, dizziness and, in extreme cases, death.

Although it does not help the rapid heartbeats usually associated with atrial fibrillation (AF), a pacemaker does control the heartbeat, making it regular and normal. Because AF is still present, risk of stroke continues and blood thinners are still needed.

Who implants the pacemaker?
A team of medical professionals led by a cardiologist performs the treatment.

How is the pacemaker implanted?
Implantation is a minor surgical procedure that takes about an hour. You are given a local anesthetic and a mild sedative to help you relax, and you remain awake during the procedure.

The cardiologist makes an incision just below the collarbone. Using real-time x-rays displayed on a video screen for guidance, the surgeon inserts wires into a vein then into the heart. The other ends of the wires are connected to the pacemaker, which is then implanted beneath the skin under the collarbone.

Is it safe?
Pacemaker implantation is safe. But, as with all surgical procedures, complications can occur, including bleeding or infection at the site where the pacemaker is inserted, damage to a vein and perforation of one of the chambers of the heart. Some people feel the pacemaker under the skin, but carrying a pacemaker is painless.

How should I prepare for the implantation?
You should not eat or drink anything after midnight the night before the procedure. Be sure to tell your doctor what medications you are taking, whether you have any allergies and if you are pregnant. You may have to prepare for an overnight hospital stay, although most patients go home the same day.

What can I expect after the pacemaker is implanted?
After the procedure, you may stay in the hospital for a day or two while staff monitors your heart and makes sure there is no bleeding or infection at the site where the pacemaker was implanted.

What happens after I return home?
For about a week after returning home, you should keep the site dry where the pacemaker was implanted and avoid strenuous activity. After a week or so, you should be able to resume your normal activities.

Today’s pacemakers are highly effective. They are not affected by airport metal detectors or by household appliances. However, cell phones, particularly digital cell phones, may interfere with a pacemaker. Always keep your cell phone at least six inches away from your pacemaker. You should also avoid strong magnetic fields. Ask your doctor about safeguards and what to do in an emergency.

You will need to see your doctor for follow-up visits and for checkups of your pacemaker. Follow-up visits and checkups are painless. In some cases, a pacemaker can be checked over the telephone. Your doctor will schedule your visits and checkups.