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by EBSCO Medical Review Board

Definition

This is a procedure to insert an artificial pacemaker. A pacemaker is a small, battery-operated device. It helps maintain a normal heartbeat by sending electrical impulses to the heart. It may be used short term or long term. It depends on why it is being used.

Pacemaker Insertion
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Reasons for Procedure

A pacemaker can be inserted for:

  • A heart that beats too slowly and often unevenly
  • A heart that sometimes beats normally and sometimes beats too slow or too fast
  • Severe heart failure and cardiomyopathy (weakened heart muscle)
  • Heart surgery

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Infection
  • Pacemaker problems
  • Spasms in the area between the chest and belly
  • Rupture in the heart muscle—rare

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The doctor may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from the procedure
  • Tests that will need to be done before the procedure

Anesthesia

The doctor will give local anesthesia—the area will be numbed.

Description of the Procedure

A small incision will be made beneath the collarbone. The pacemaker is placed through the incision. The wires will be threaded through a vein from the collarbone to the heart. The incision is then closed with stitches. A bandage will be placed over the site.

How Long Will It Take?

About 2 hours

Will It Hurt?

Pain is common in the first few days after the procedure. Medicine will help.

Average Hospital Stay

Some can go home on the same day. Others may need to stay in the hospital for a day or so.

Post-procedure Care

At the Hospital

At the care center, staff will take steps to lower your risk of infection, such as:

At the care center, staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incision covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incision
At Home

Recovery will take a week or so. Physical activities may be limited during that time.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Fever or chills
  • Excess bleeding, redness, swelling, or discharge from the incision
  • Pain that you cannot control with the medicines
  • Coughing, problems breathing, or chest pain
  • Fast, slow, or uneven heartbeats

If you think you have an emergency, call for medical help right away.

RESOURCES

American Heart Association  http://www.heart.org 

Heart Rhythm Society  https://www.hrsonline.org 

CANADIAN RESOURCES

Canadian Cardiovascular Society  http://www.ccs.ca 

Heart and Stroke Foundation  http://www.heartandstroke.ca 

References

Madhavan M, Mulpuru SK, et al. Advances and future directions in cardiac pacemakers: part 2 of a 2-part series. J Am Coll Cardiol. 2017;69(2):211-235.

Pacemaker insertion. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pacemaker-insertion. Accessed September 8, 2021.

Pacemakers. EBSCO DynaMed website. Available at: https://www.dynamed.com/device/pacemakers . Accessed September 8, 2021.

What is a pacemaker? American Heart Association website. Available at: https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/pacemaker#.W0O4YtVKhQI. Accessed September 8, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/08/2021