Pacemaker implant

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If your heart beats too fast, too slow or irregularly, you may have a heart arrhythmia, or abnormal heartbeat. A pacemaker implant can help restore your heart to a normal rate and rhythm.

Our board-certified electrophysiologists are here to guide you from diagnosis to treatment so we can help get your heart back to a normal beat.

Types of pacemaker implants

To help your heart automatically maintain a predictable rhythm, we’ll permanently implant a battery-powered pacemaker into your chest. With a heart pacemaker in place, you may begin to feel much better. Your symptoms of arrhythmia, such as tiredness and syncope (fainting), may improve.

Your doctor will determine which kind of device you need depending on the type of heart rhythm issue you’re experiencing.

Many pacemakers have one or two wires, called leads, that connect to your heart and help keep your heart rate normal. A single chamber pacemaker uses one lead connected to either an upper or lower chamber of your heart while a dual chamber implant connects to both chambers. 

For some people, we can also use new leadless (wireless) pacemakers. This helps people who have a slow heart rate and need a pacemaker to help in a single heart chamber.

Sometimes pacemakers can also be used in patients with very symptomatic atrial fibrillation (AFib) where no other therapy has worked. In this situation, the electrical connection between upper and lower chambers is disconnected and pacemaker used to control the heartbeat. This procedure can improve quality of life in patients where other treatments have failed. 

For serious arrhythmia, which can occur in patients with serious heart disease and can cause your heart to go into cardiac arrest, we can implant a pacemaker that includes an implantable cardioverter defibrillator. The device sends a small electrical charge to your heart to restore a normal heart rhythm.

We also can implant a biventricular pacemaker or a defibrillator. These devices keep both lower chambers of your heart pumping at the same time and syncs them with the upper chambers. Your doctor might suggest this if your heart failure makes the chambers contract at different times, creating an inefficient heartbeat that stresses your heart, and can leave you tired and short of breath.

Prior to the procedure, you’ll see an electrophysiologist to discuss which type of procedure may benefit you the most and to prepare for the procedure including:

  • Refraining from eating or drinking anything after midnight the night before your procedure
  • How to get ready for your procedure including any medications you may need to stop taking
  • Answering your questions and concerns
  • Need for medications and if you’ll need more than one procedure

Your implantation procedure will take place in a lab or a special surgical suite. The procedure usually takes two to four hours.

On the day of the procedure, we’ll disinfect and may shave a small area on your upper chest where we make the incision to insert the pacemaker or defibrillator. You’ll receive a local anesthetic as well as sedation, so you’ll be comfortable while your doctor implants your pacemaker or defibrillator. 

We’ll monitor your heart’s electrical activity using an electrocardiogram (EKG) machine. We also follow your heart rate, blood pressure and breathing during and after the procedure.

You may feel us pushing on your shoulder during the procedure, but you shouldn’t feel any pain. We’ll make sure you’re comfortable throughout the process.

You’ll most likely stay overnight in the hospital while you recover so we can make sure your device is working well, but we may be able to send you home the same day. When it’s time to go home, you’ll need someone to drive you home and stay with you for a few days. You also might want to take off a few days from work to give your body time to heal.

We’ll customize your program with your pacemaker or defibrillator to help manage your heart arrhythmia. We’ll also regularly check your pacemaker using remote, computerized and automatic monitoring.

It’s common to feel a little sore after the procedure, but that goes away gradually. We’ll give you some mild pain medication and tell you which other medication(s) to continue or stop taking.

Before going home, we’ll go over detailed instructions about your recovery including:

  • Exercise: Your doctor will give you detailed instructions and guidelines on what kind of physical activity is safe in the first few months after your implant.
  • Follow-up appointments: Be sure to keep these appointments so your doctor can test and reprogram the pacemaker to best fit your needs.
  • Remote monitoring: Your pacemaker will regularly transmit messages to our monitoring team so we can see how well the device is working. However, you’ll still need to come in for appointments on occasion.
  • Living with your new device: Most people with pacemakers find that they can quickly resume their everyday activities. Be sure to let your medical and dental professionals know that you have a pacemaker. You’ll also need to alert screeners at the airport as your device may set off metal detectors at the airport.

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