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The Pacemaker Implant Procedure


Fishing gives Donald Williams a sense of peace. So, does the knowledge that his abnormal heart rhythm is under control thanks to a pacemaker… a device that helps his heart beat normally. For Donald, the process of implanting the pacemaker in his chest wasn’t a big deal.

“For me, this was all a new experience. Less a scary one, more one in which I was more curious about how these trained people go about their business.” – Donald, Patient

To increase the chances of your pacemaker implant procedure going smoothly, as Donald’s did, it’s important to follow instructions. For one week before the procedure, don’t shave near the area where the pacemaker will be implanted, but you can shower. Your health care team may instruct you to wash the surgery site with a special soap the night before and the morning of your procedure.

Don’t eat or drink after midnight the evening before your surgery. However, it’s ok to drink small amounts of water to take medication. Your health care provider may have you temporarily stop certain medications.

“It is important to notify your physician of which medications you're taking. There are certain drugs that are not compatible, or should be discontinued prior to a procedure. – Gabriel Breuer, MD Cardiac Electrophysiologist

Before the procedure, you will be required to sign a consent form. As with any procedure, there are risks associated with implanting a pacemaker. Among them: infection, severe bleeding and a collapsed lung.

Maria, who had her first implant procedure several years ago, says discussing her concerns with the health care team helped make her feel more prepared.

“Get your questions written down. Ask everything. It's their job to tell you. There's no stupid questions, and there's no questions that you should be embarrassed about." – Maria, Patient

Pacemakers are implanted in either the left or right side of the chest. Your health care team will likely ask which side you prefer. Like many patients, Donald based his decision on which arm he uses most.

“I chose the left side because I'm right-handed, and on the left side there's less movement, I don't lift, I don't do as much with my left hand.” – Donald, Patient

Prior to your procedure, you’ll be given medications to relax you and numb the surgical site. In some cases, general anesthesia, which puts you to sleep, may be used.

“They give you something to calm you down, they start talking to you, and before you know, you're asleep, and I don't remember anything after that.” – Maria, Patient

An incision about three inches long will be made near your collarbone in order to form a pocket just under the skin, where your doctor will implant the pulse generator, which is the power source.

A wire – called a lead -- will be threaded through a vein and into your heart. Depending on your condition, more than one lead may be inserted. Over a period of weeks, the ends of the leads will embed in the heart muscle.

Once the pulse generator and leads are connected, the system is checked to make sure it’s working properly. After the surgical team finishes, they’ll move you to recovery, where you will continue to be monitored. It’s common for patients to be able to get out of bed just a few hours after

“I was walking the day of the surgery. That night in the hospital, I could sit up. I could walk to the chair, so I was up and moving.” – Maria, Patient

However, you may have some discomfort and need to keep your arm in a sling for a while.

“When patients undergo insertion of a device, we advise them not to lift the right or left arm depending on where the device is above their should level for approximately six weeks. That is just to make sure that the leads stay in place.” - Gabriel Breuer, MD Cardiac Electrophysiologist

By following the advice of his health care team, Donald was able to get back to the activities he enjoys relatively quickly.

“I did what I was told, and nothing happened. Everything seems fine, but you do have to follow instructions.” – Donald, Patient

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