Pacemakers What to Expect

The procedure may be planned ahead of time, or it may be done during an emergency (temporary pacemaker). You will be given medicine to make parts of your body numb or make you sleep during the procedure. 

You may receive antibiotics to prevent infection and blood thinning medicine to prevent blood clots during the procedure. Different types of pacemakers require different procedures to place them. 

Wired transvenous pacemakers

Many traditional, and all temporary, pacemakers are transvenous pacemakers, meaning the wires and electrodes are threaded through your veins. A doctor will thread the electrodes and wires through the veins in your neck, chest, or thigh, to the chambers of your heart. The electrodes are put in your heart muscle. The doctor may use echocardiography or X-ray to guide the process. 

Once the wires are in place, your doctor will make a small cut into the skin of your chest or abdomen. He or she will slip the device with the generator just under the skin, then connect it to the wires that lead to your heart. Your doctor will test to see if it the device works properly and then sew the cut up. The entire surgery may take up to a few hours.

Watch the video below to learn more.

This animation shows how a wired transvenous pacemaker is placed. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.

You probably will not be allowed to move your arm for at least 12 hours after the procedure. This will help prevent disturbing the lead and the device and let your chest heal. 

Epicardial pacemakers

With epicardial pacemakers, the electrodes are attached to the surface of the heart rather than inside its chambers. This is a surgical procedure done under general anesthesia. Your doctor will make a cut below your ribs or armpit to place the pacemaker. Epicardial pacemakers are used as a standard precaution during heart surgery. 

They may also be used: 

  • When a vein is blocked by a blood clot or plaque 
  • When it would be difficult to insert the wires inside your heart chamber because of the structure of your heart or veins 
  • When they are needed by newborns or children, who are the most common users 
  • If you have a heart infection 

Wireless pacemakers

Wireless pacemakers are a newer type of pacemaker. The pulse generator and electrodes are all in one small device that is placed inside the heart. 

A doctor will thread a tube (called a catheter) through a vein in your thigh up to your heart. The catheter moves the pacemaker using X-ray images to place it in a heart chamber. 

The procedure often takes less than an hour, and you may be able to leave the hospital the same day. Typically, the recovery time is faster and the risk of infection is lower. The battery life of the device is between 8 and 13 years. 

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