PACEMAKER INSERTION

What is a Pacemaker?

A pacemaker is a small device that is placed in the chest to help control abnormal heart rhythms. This device uses wires to carry electrical pulses to the heart muscle, which prompts the heart to beat at a normal rate.

Why would I need a Pacemaker?

Pacemakers are used to treat abnormal rates or rhythms of the heart. If the heart beats abnormally it may not be able to pump enough blood to the body. This can cause symptoms such as fatigue, shortness of breath or fainting. A pacemaker may relieve these symptoms.

Your doctor may recommend a pacemaker if you have one of the following:

Bradycardia (slow heart rate)
Atrial Fibrillation (irregular heart beat)
Heart Failure
Syncope (Fainting).

What to expect prior to the procedure

You must not eat or drink for 6 hours prior to the procedure.
You will be asked to have a shower with an antiseptic sponge and change into a hospital gown. Men with hairy chests will require a small area to be shaved.
The procedure can take 1-2 hours so you should empty your bladder just before going to the Catheter Lab.
You will have an ECG and some blood taken for routine tests. If you have not had a recent chest xray, one may be taken.
Your doctor will visit you to explain the procedure and answer any questions you may have. You will be asked to sign a form consenting to the procedure.
An IV cannula will be inserted into a vein in your arm so that medication can be given.
Your doctor will give you local anaesthetic to numb the area in your chest where the pacemaker will be inserted.

What to bring to hospital on the day of the procedure

Loose and comfortable clothing to wear home.
Recent chest x-rays.
Your usual medications. Medications such as Aspirin or Warfarin may be stopped prior to the procedure. Check with your doctor before altering your regime.
Toiletries.
A book or magazine to keep you occupied.
Do not bring any valuables, jewellery or excess money.
Mobile phones must be switched off inside the hospital as they interfere with sensitive electronic equipment.

Recovery Period

You will be able to get out of bed whenever you wish.
You will be monitored while you are walking around.
Moving your left arm may cause some discomfort. You are advised not to lift that arm above your head for at least 4 weeks after the procedure.
The nurses will help you have a wash and change into some night clothes. You will be able to eat and drink as normal, and walk to the toilet.
If you have any discomfort, inform the nurse so that they can give you a mild painkiller.
You will have a routine ECG performed.
The nurses will regularly check your wound for any bleeding or swelling.

Day of Discharge

The day after your procedure you will have a repeat chest x-ray performed to ensure the correct position of the pacemaker wires.
A representative from the pacemaker company will come and check your pacemaker before discharge. They will give you a booklet that will tell you about your pacemaker.

Your Cardiologist may change your medications but this will be explained to you.
You may need some mild painkillers at home, tell the nurse if you require us to get them from the pharmacy prior to your discharge.
If you normally take a blood thinner, the doctor will tell you when to recommence this.

After discharge from hospital

The dressing on your chest must remain intact for 7 days. The dressing only needs changing if it lifts off. It is a good idea to have this done by a nurse at your GP’s surgery. If this is not an option contact your Cardiologist’s rooms and they will make an alternative arrangement.

After 7 days, remove the dressing from your chest then gently wash the wound in the shower and carefully dry with a clean towel. Report to your doctor if there is any discharge from the wound. You may be asked to attend the Cardiologist’s rooms for a wound check.

You should not do any heavy lifting or straining for 4 weeks. During this time it is important that you do not lift your left arm above your head, as this could cause the pacemaker wires to dislodge.

You will be given a temporary identity card before you are discharged. You will receive a permanent one in the post in a few days. It is important to carry this card with you at all times. It is a good idea to let a close friend or family member read the pacemaker booklet and familiarise themselves with the information.

You will need to make an appointment to see your GP in a few days time and you will be given a discharge letter to give to them.
Your Cardiologist will ask you to make an appointment to see him at a later date.

If you have any concerns when you go home, you can ring us on (07) 4052 5230 or contact your GP.

If you have further questions regarding this procedure, please ask your nurse or doctor for clarification.