Pacemakers

The pacemaker is the size of a matchbox. It contains an electric circuit and a long life battery. The pacemaker is usually placed under the skin just below your collarbone and gives electric impulses through one or more leads that run down a vein to your heart.

What causes abnormal heart rhythm?

Your heartbeat is controlled by electric impulses from a group of cells on your heart called the sinus node. When the heart beats normally, the electric impulses cause the upper chambers (atria) and the lower chambers (ventricles) to contract and relax in a coordinated way. 

A pacemaker is usually recommended to treat bradycardia, where the ventricles beat much more slowly than they should resulting in less blood flow.

Why do I need a pacemaker?

You may be at risk of developing or have had an abnormal heart rhythm. Serious cases of bradycardia can cause cardiac arrest (when your heart stops working) and even death. Other symptoms include dizziness or collapsing (blacking out), feeling breathless or getting swollen legs. 

A pacemaker is designed to sense if your heartbeat is too slow and to give short electric impulses or paced beat to stimulate your heart to beat (pacing).

Before your procedure you will have an electrocardiogram (ECG) to trace the electrical activity or your heart.

What happens during pacemaker surgery (pacemaker insertion)?

Pacemaker surgery is usually done under local anaesthetic. You may be offered a sedative or painkiller. Be sure and ask if you are at all worried about this procedure. Once the anaesthetic takes effect you will be numb. You may feel a slight pulling sensation during this procedure.

Your surgeon will make a cut just below your collarbone and pass a lead down a vein in your heart. If you need more that one lead your surgeon will repeat this procedure. They will create a small pocket under the skin just below your collarbone to insert the pacemaker. With everything in place your surgeon will test the pacemaker to ensure everything is working. 

Pacemaker surgery usually takes between 30 and 60 minutes.

What to expect after pacemaker surgery

You may stay in hospital one to two days. Our Healthcare Team will closely monitor your heart rhythm during your stay. You may have a chest x-ray to check the position of your pacemaker and leads. 

You may experience some discomfort or pain following your operation. Please be sure and let our Healthcare Team if you are in pain. There may be bruising and soreness where the pacemaker is inserted.

Going home after pacemaker surgery

You will not be able to drive for about one week. Please arrange for someone to drive you home when you are discharged. You will need to inform your insurance company and the DVLA that you have a pacemaker. 

You should keep your wound dry until any stitches or stapled are removed (within 10 -14 days post surgery). 

You should avoid any strenuous activity or lifting for about three to four weeks. Avoid reaching up with the arm on the pacemaker side. You may be given exercises to keep your arm and shoulder mobile. 

Most patients make a full recovery and return to normal activities four to six weeks after their surgery. 

You may be asked to return to have your pacemaker checked after four weeks. At this time your surgeon may make some small adjustments to your pacemaker. After your first check you will need regular checks every three to twelve months.

Living with your pacemaker

Most everyday household appliances do not interfere with your pacemaker. However there is a risk of electro-magnetic field interference.  

Specific items to note are:

• Mobile phones - do not carry or use a mobile phone within six inches (15 centimetres) of your pacemaker. Use the ear on the opposite side or a headset
• Security systems - avoid standing too long near any electronic security systems such as those used at airports or shop entrances
• MRI scans - most pacemakers and pacing leads are now MRI safe, as long as manufacturers are not mixed. A cardiac physiologist would change how the pacemaker works for the duration of the MRI scan and reprogram it back after the MRI scan.

Be sure and discuss your current job with your surgeon. If your work includes contact with strong electrical fields such as certain types of welding, working on TV or high power radio transmitters or car ignitions discuss your return to work with your surgeon.

Most people make a good recovery and return to normal activities following pacemaker insertion. As with any surgery there can be complications:

• Pain
• Bleeding
• Bruising
• Infection of the surgical site (incision)
• Lead moving out of place
• Pacemaker develops a fault
• Pacemaker battery coming through the skin
• Blood clots
• Allergic reaction to the equipment or drugs
• Radiation exposure

Why not print this treatment page so you can discuss any concerns you have with your surgeon?