Heart pacemaker - discharge





You had a pacemaker placed in your chest to help your heart beat properly.
  • A small cut was made on your chest below your collarbone. The pacemaker generator was then placed under the skin at this location.
  • Leads (wires) were connected to the pacemaker, and one end of the wires was threaded through a vein into your heart. The skin over where the pacemaker was placed was closed with stitches.
Most pacemakers have only one or two wires that go to the heart. These wires stimulate the right or left side of the heart when the heartbeat gets too slow.
Some pacemakers also can deliver electric shocks to the heart that can stop life-threatening arrhythmias (irregular heartbeats). This is called a "cardioverter defibrillator."
You should know what type of pacemaker you have.

What to Expect at Home

You will be given a card to keep in your wallet.
  • The card has information about your pacemaker and includes your doctor’s name and telephone number. It also tells others what to do in case of an emergency.
  • You should always carry this wallet card with you. It will be helpful to any health care provider that you may see in the future because it says what kind of pacemaker you have.
You should wear a medic alert bracelet or necklace that says you have a pacemaker. In a medical emergency, health care workers taking care of you should know you have a pacemaker.

Be Careful Around Things with Magnets

Most machines and devices will not interfere with your pacemaker. But some with strong magnetic fields may. Always ask your doctor or nurse about any specific device that you need to avoid. Do not put a magnet near your pacemaker.
Most appliances in your home are safe to be around. This includes your refrigerator, washer, dryer, toaster, blender, computers and fax machines, hair dryer, stove, CD player, remote controls, and microwave.
You should keep several devices at least 12 inches away from the site where the pacemaker is placed under your skin. These include:
  • Battery powered cordless tools (such as screwdrivers and drills)
  • Plug-in power tools (such as drills and table saws)
  • Electric lawn mowers and leaf blowers
  • Slot machines
  • Stereo speakers
Tell all health care providers that you have a pacemaker before any tests are done.
Some medical equipment may interfere with your pacemaker.
Stay away from large motors, generators, and equipment. Do not lean over the open hood of a car that is running. Also stay away from:
  • Radio transmitters and high-voltage power lines
  • Products that use magnetic therapy, such as some mattresses, pillows, and massagers
  • Large electrical- or gasoline-powered appliances
If you have a cell phone:
  • Do not put it in a pocket on the same side of your body as your pacemaker.
  • When using your cell phone, hold it to your ear on the opposite side of your body.
Be careful around metal detectors and security wands.
  • Handheld security wands may interfere with your pacemaker. Show your wallet card and ask to be hand searched.
  • Most security gates at airports and stores are okay. But do not stand near these devices for long periods. Your pacemaker may set off alarms.
After any operation, have your doctor check your pacemaker.

Wound Care

You should be able to do normal activities in 3 - 4 days.
For 2 - 3 weeks, do not do these things with the arm on the side of your body where the pacemaker was placed:
  • Lifting anything heavier than 10 - 15 pounds
  • Too much pushing, pulling, or twisting
Do not lift this arm above your shoulder for 6 weeks. Do not wear clothes that rub on the wound for 2 or 3 weeks. Keep your incision completely dry for 4 - 5 days. Afterward, you may take a shower and then pat it dry. Always wash your hands before touching the wound.

Follow-up

Your doctor or nurse will tell you how often they will need to check your pacemaker. Most times, it will be every 6 months to a year. The exam will take about 15 - 30 minutes.
The batteries in your pacemaker should last 6 - 15 years. Regular checkups can detect if the battery is wearing down or if there are any problems with the leads (wires). Your doctor will change the generator along with the battery when the battery gets low.

When to Call the Doctor

Call your doctor if:
  • Your wound looks infected (redness, increased drainage, swelling, painful).
  • You are having the symptoms you had before the pacemaker was implanted.
  • You feel dizzy or short of breath.
  • You have chest pain.
  • You have hiccups that do not go away.
  • You were unconscious for a moment.

Alternate Names

Cardiac pacemaker implantation - discharge; Artificial pacemaker - discharge; Permanent pacemaker - discharge; Internal pacemaker - discharge; Cardiac resynchronization therapy - discharge; CRT - discharge; Biventricular pacemaker - discharge

References

Swerdlow CD, Hayes DL, Zipes DP. Pacemakers and implantable cardioverter-defibrillators. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 38.