Pacemaker Implantation

A Pacemaker is implanted in a patient’s chest to regulate the heart rate. The patient is scrubbed and draped, and sedated via IV; ideally the patient is comfortable, but not completely unconscious. The chest is numbed under the collarbone (usually on the left, if the patient is right-handed) and the cardiologist makes a small incision. A small pocket is created in the chest wall to hold the pacemaker unit, and then the doctor threads leads through the incision through a large blood vessel and into the heart. The leads are connected to the pacemaker unit, which is then secured in the pocket. The incision is closed using sutures which dissolve over time. The patient will usually stay the night at TMCA for monitoring, with the affected arm in a sling, to avoid disturbing the leads. After release, the patient is instructed to keep the dressing clean and dry for 3 days, and to avoid lifting the affected arm above the head for 2-4 weeks.

Pacemakers that we use come from one of several companies, and the representative from that company will be present before, during and after the procedure. The doctor and the representative will be able to answer questions a patient may have about the particular unit chosen for installation. The representative provides the patient with a temporary ID card, and later the patient will be sent a permanent ID card from the manufacturer.

Preparation for a pacemaker implant includes not eating or drinking for at least 6 hours before the procedure, except for sips of water to swallow regular medications. Some patients may be instructed to suspend the use of blood thinners for a few days in advance of the surgery. The patient can expect to receive detailed pre- and post-operative instructions by phone. We ask pacemaker patients to check in at TMCA in the Surgery Waiting Room (near the gift shop) 2 hours before their procedure start time.