A pacemaker is a small device that will correct a problem with your heart's electrical system and keep your heart contracting and pumping blood. The pacemaker's generator and batteries are surgically implanted under the skin, usually in your chest wall near your collarbone, and one or two lead wires are permanently placed into your heart.

The pacemaker is always sensing your own heartbeats to make sure you have a regular rhythm. It paces your heart only after it does not detect heartbeats for a certain period of time. Your pacemaker runs on batteries and sends out electrical impulses that keep your heart beating at its proper speed.

The pacemaker has two parts:

  1. A pulse generator, which is the battery/timer unit. It is about the size of two silver dollars stacked together. Pacemakers usually last from four to eight years.
  2. One or more electrodes and wire leads that carry the electrical impulses to the heart.

In many cases, less than an hour of surgery is required to implant your pacemaker. In fact, many pacemaker implants are done as an outpatient procedure. Most patients receive a local anesthetic and remain awake during surgery. Some types of pacemaker implants require general anesthesia and a brief hospital stay. Ask your physician for specific details.

How do I prepare for my pacemaker implantation?

Your physician will give you specific instructions for the night before your pacemaker implant surgery depending upon a number of issues, including the type of procedure being performed, the type of pacemaker being implanted, your physical condition and other considerations. Some typical instructions include:

  • It is important for you to have an empty stomach for surgery. Do not eat or drink any fluids after midnight before the procedure.
  • Regarding your regular medications, you may or may not need to take them. Your physician will discuss this with you.
  • When you check in to the hospital, wear comfortable clothes and shoes. Don't wear jewelry or bring valuables. Pack any personal care items you will want for an overnight or brief stay, depending upon whether your surgery will be inpatient or outpatient.

What will the pacemaker implantation be like?

When you arrive at the hospital, you will consult with your physician prior to the procedure. You will receive a sedative and an anesthetic intravenously.

The pacemaker's lead or leads will be threaded into and secured to the muscle in your heart before the pacemaker generator/battery unit is inserted. Then, your pacemaker will be implanted into your chest or in the abdominal area, depending upon your condition, age and lifestyle. Your physician will describe the specific procedure your pacemaker implantation will involve.

Certain types of pacemakers are implanted as outpatient surgery. In other circumstances, you will be observed in the hospital overnight after the surgery. You may be taken to an intermediate care unit where hospital staff will monitor your heart to make sure that your pacemaker is working properly.

You may feel mild discomfort from the site where the incision was made to implant your pacemaker. Contact your physician if you experience increasing discomfort or fever.

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Lowell Tilzer, MD

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Clinical Pathology

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