Common Questions About Pacemakers

What happens after the procedure?
You will be admitted overnight so your heart rate and rhythm. The morning after your implant, you will have a chest X-ray to insure the leads are in proper placement. Your device will be checked by the device clinic or a company representative to insure the device is at the optimal settings.

You will be shown how to take care of you wound site. Keep it clean and dry to prevent the chance of infection. After three to five days, you may take a shower. Look at the wound every day to make sure it is healing well.

Call your doctor if you see any of the following:

• Increased drainage, bleeding, or oozing from the insertion site.
• If the wound appears to be opening at the incision site.
• Redness, swelling or warmth around the site.
• Fever or chills

You will be given a temporary ID card before you leave the hospital. The card will have the following information:

• The type of the model of the device, the lead information, date of implant, and the physician who implanted the device.

You should receive a permanent cared from the pacemaker company in about three months. You should carry this card with you at all times.

Do I have any restrictions from moving around after the implant?
You will be able to move around normally.

You will have some restrictions with your arm on the side the pacemaker was placed:

• Do not lift objects that weigh more than 10 pounds, including children and pets.
• Do not raise your arm above your shoulder as determined by your physician.
• Avoid pushing, pulling heavy objects such as shoveling, mowing the lawn
• No golfing, tennis, or swimming for six weeks after the procedure.
• Try to walk as much as possible for exercise.
• Your doctor will tell you when you can go back to work and do strenuous activities.

Do cellular phones interfere with pacemakers?
The answer to this question depends on the type of cellular phone being used. Pacemakers are engineered to withstand interference from analog cellular phones which are being phased out. However, in some cases, digital cellular phones may interfere with pacemakers. It is best not to carry the phone in your shirt pocket on the same side as your phone. Use the phone on the opposite side from the device or use a head set.

How long does a pacemaker last?
Pacemakers can last anywhere from 5 to 10 years or more —on the average about seven years. Device longevity depends upon how hard the battery inside the pacemaker has to work. This is affected by how much energy is required to pace the heart and how the system is programmed. Thanks to ongoing research and development, the life of pacemakers continues to increase as their size decreases, making them more comfortable for people. Replacing a pacemaker may be done on an outpatient basis or may include an overnight stay in the hospital. Your length of stay will depend if the leads need to be changed or if only the device is changed out.

Will I feel the pacemaker?
At first, you may feel the weight of the pacemaker in your chest. However, over time, most people become accustomed to the pacemaker and forget it is there. The generator is small, about the size of two or three silver dollars placed on top of each other, and weighs about an ounce or less, depending on the manufacture and model of the device.

Are there different types of pacemakers?
There are different types of pacemakers:

• Single chamber pacemaker uses one lead in the upper chambers (atria) or lower chambers (ventricles) of the heart.
• Dual chamber pacemaker uses one lead in the atria and one lead in the ventricles of your heart.
• Cardiac resynchronization therapy (CRT) pacemaker uses three leads: one placed in the right atrium, one placed in the right ventricle, and one placed in the left ventricle (via the coronary sinus vein).

Your physician will be able to explain which device is best for you.

Can patients with a pacemaker live an active life style such as tennis, skiing, jogging or have sexual relationships?
Typically, pacemaker patients can continue to lead active lives. If you did a certain activity before, more likely than not, you'll be able to continue that activity after pacemaker implantation. In fact, you should be able to participate in most activities. Because people may have more energy after the pacemaker is implanted, they may be able to do more than they have been able to do for some time. If there are special activities that a patient would like to participate in, this needs to be discussed with the physician prior to the procedure, as it may affect the device that is selected and how it is implanted.

After making an end of life treatment decision, what are my options in turning off a cardiac pacemaker? How will I or my loved one be able to die if the pacemaker will keep the heart going?

This is a common misunderstanding. A pacemaker does not actually beat for the heart, but delivers energy to stimulate the heart muscle to beat. Once someone stops breathing, their body can no longer get oxygen and the heart muscle will die and stop beating, even with a pacemaker. Therefore, a patient will die without turning off their pacemaker. While turning off a pacemaker is certainly something that can be done, it is generally not something that needs to be done. Unlike an ICD, turning off a pacemaker can frequently make you or your loved one feel considerably worse by reducing the blood supply to the body. But f you or your loved one are in a continuing state of reduced consciousness or in the dying process, and the pacemaker is felt to be the main treatment sustaining life, then consideration of turning off the pacemaker may be in line with your overall wishes. Learn more about handling death and dying issues with a cardiac pacemaker »

What is EMI?
EMI means electromagnetic interference. Certain types of electrical or magnetic energy can interfere with your pacemaker’s operation. You should do your best to avoid major sources of EMI.

What causes EMI?
EMI or electromagnetic interference can be caused by:

• Electrical appliances in poor condition or not grounded correctly
• Electrical equipment that produces a great deal of energy, like industrial generators or car alternators
• Certain devices, notably arc-welders
• Medical equipment including MRI devices, therapeutic radiation, and TENS (pain-control devices)

What electrical equipment is safe to use?
Most home appliances in good working order are safe to use. This includes microwave ovens, blenders, toasters, electric knives, ultrasonic dental cleaners, televisions, VCRs, electric blankets, electric stoves, and garage door openers.
Office equipment and most medical equipment are safe to use. The pacemaker will work properly during chest and dental x-rays, diagnostic ultrasound, CT scan, mammography, and fluoroscopy.

What should I do if I am near a source of EMI?
In most cases you can just walk away from the EMI source or turn it off. At airports, show the security personnel your pacemaker identification card so that you do not have to walk through the metal detector. If you feel symptoms such as lightheadedness or palpitations after being near an EMI source, contact your doctor.