Procedures

Cardiac Device

Pacemaker Implantation

The heart has a natural pacemaker and an electrical system that directs the heart muscle to beat. Sometimes problems can arise either in the heart’s natural pacemaker or with the electrical system that can cause the heart to beat too slowly or stop. A permanent mechanical pacemaker is then inserted to take over the deficient natural electrical source.

A pacemaker is implanted to replace your natural system. It is made up of a pulse generator that lies under the skin just below the collarbone (usually) and 1 to 3 leads that arise from the pulse generator and go into the heart. The leads transmit the electrical impulses from the pulse generator to the heart muscle causing it to beat.

A small image of a hand holding a Medtronic heart device

What is involved in a pacemaker implant?

Insertion of a pacemaker is a very common procedure. This is performed under general anaesthetic but can performed under local anaesthetic and sedation as well. The procedure takes approximately 1 hour and is performed in the cardiac catheter laboratory. This is a special room that has a patient table, X-Ray tube, ECG monitors and other equipment. The staff in the lab will all be dressed in hospital theatre clothes during the procedure will be wearing hats and masks.

Many ECG monitoring electrodes will be attached to your chest area. A nurse or doctor will insert an intravenous line usually into the back of your hand. You will also have a blood pressure cuff attached to your arm that will automatically inflate at various times throughout the procedure. There will also be considerable attention at cleaning the skin under the collarbone where the pacemaker will be inserted. You will also receive antibiotics prior to the procedure. You should ensure that you inform the doctor is you have any allergies.

The pacemaker is inserted just under the collarbone. The area is prepared with a special sterile solution that may feel cold. A large sterile sheet that will partly cover your face will cover you. You will be able to look out from under the sheet to the side and a nurse will be present at all times. You will be given oxygen to breathe by a small tube that is positioned under your nostrils.

After the procedure

You will usually stay in hospital for one night after having a pacemaker implanted. You may experience some bruising and discomfort to the area of the pacemaker site and this may persist for one to two weeks. This can be relieved with simple pain relief such a paracetamol and ibuprofen but this should be discussed prior to taking any medications.

You should avoid strenuous activities with your arm for a period of 4 weeks – this is very important after your procedure to avoid the leads from moving. If the leads do move, you will have to re-admit to the hospital for a lead revision. You must not drive for 2 weeks after the procedure. You will be allowed to discharge home the day after the procedure and a follow up appointment will be arranged to have your device checked in the clinic.