Pacemaker insertion lifespan electricity flow diagram

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• You will be connected to an electrocardiogram (ECG) monitor that records the electrical activity of your heart and monitors the heart during the procedure using small, plastic electrodes that stick to your skin. Your vital signs (heart rate, blood pressure, breathing rate, and oxygen level) will also be monitored during the procedure.

• The lead wire will be threaded through the introducer into the blood vessel. The healthcare provider will advance the lead wire through the blood vessel into the heart. Fluoroscopy, (a special type of X-ray “movie” that is displayed on a TV monitor), may be used to help check the location of the leads.

• Once the lead wire is inside the heart, it will be tested to be sure it’s in the right location and it works. There may be 1, 2, or 3 lead wires inserted, depending on the type of device your healthcare provider has chosen for your condition.

• The pacemaker generator will be slipped under your skin through the incision (just below the collarbone) after the lead wire is attached to it. Generally, the generator will be placed on the nondominant side. (If you are right-handed, the device will be placed in your upper left chest. If you are left-handed, the device will be placed in your upper right chest).

After the period of bed rest has been completed, you may get out of bed with help. The nurse will be with you the first time you get up, and will check your blood pressure while you are lying in bed, sitting, and standing. Move slowly when getting up from the bed to avoid any dizziness.

The insertion site may be sore or painful. Pain medicine may be taken if needed. Your arm may be placed in a sling overnight. Your provider will give you specific instructions on any activity restrictions and about immobilizing your arm after the procedure. You will have a chest X-ray to make sure the lung was not injured during the procedure, and to check the device position. You may be prescribed antibiotics to protect you from an infection around your pacemaker or at the incision site.

You should be able to return to your normal daily routine within a few days. Your healthcare provider will tell you if you will need to wait before returning to your normal activities. Do not do any lifting or pulling for a few weeks. You may need to limit movement of the arm on the side that the pacemaker was placed.

Ask your healthcare provider when you will be able to return to work. The nature of your work, your overall health, and your progress after surgery will determine how soon you may go back to work. Call 911 if you have severe, unrelenting chest pain or trouble breathing.

After a pacemaker insertion, regularly scheduled appointments will be made to ensure the pacemaker is working the way it should. The healthcare provider uses a special computer, called a programmer, to review the pacemaker’s activity and adjust the settings when needed.

• Let security screeners know you have a pacemaker before going through security detectors at the airport or court house. In general airport detectors are safe for pacemakers, but the small amount of metal in the pacemaker and leads may set off the alarm. If you are selected for additional screening by hand-held detector devices, politely remind the screeners that the detector wand should not be held over your pacemaker for longer than a few seconds, as these devices contain magnets that may affect the function or programming of your pacemaker.

• If you need a surgical procedure in the future, be sure to let the surgeon know that you have a pacemaker well before the operation. Also ask your cardiologist’s advice on whether anything special should be done before and during the surgery, the electrocautery device that controls bleeding may interfere with the pacemaker. Sometimes the pacemaker’s programming will be temporarily changed (using a magnet) during the surgery to minimize the possibility of interference from the electrocautery.

• When involved in a physical, recreational, or sporting activity, protect yourself from trauma to the pacemaker. A blow to the chest near the pacemaker can affect its functioning. If you are hit in that area, you may want to see your healthcare provider to make sure your pacemaker is working the way it should be.

• Cell phones in the U.S. with less than 3 watts of output do not seem to affect pacemakers or the pulse generator, but as a precaution, keep cell phones at least 6 inches away from your pacemaker. Do not carry a cell phone in your breast pocket over your pacemaker.