Cardiology - A Guide to your Pacemaker Procedure

If you have any concerns about preparing for your pacemaker, contact: 0161 206 5005 or 0161 206 5006

Permanent Pacemaker

You have been advised by your doctor to have a permanent pacemaker inserted.

PLEASE READ THIS LEAFLET CAREFULLY

Why do I need a pacemaker?

A pacemaker prevents your heart from beating too slowly. The pacemaker is designed to improve symptoms of light headedness or loss of consciousness, or to prevent these from occurring in the future.

What is a pacemaker?

A pacemaker consists of either one or two leads which are placed within the heart via the veins and attached to a generator, or “box”, that is implanted under the skin of the chest.

A pacemaker works by constantly monitoring your own heart rate and responding when this rate drops below a set level. The pacemaker will painlessly stimulate the heart to beat as is necessary, until your own heartbeat takes over again.

How long will my pacemaker last?

Most pacemaker batteries last for 10-13 years. This is monitored carefully at your yearly check-up at a pacing outpatient clinic.
Your cardiologist will make arrangements in advance when your pacemaker battery needs replacing.

Implantation

To have your pacemaker inserted you will be admitted to the Heart Care Unit (HCU) on the morning of your procedure. This is a day case procedure. You will be discharged home late afternoon.

The procedure is carried out in the theatre in the Heart Care Unit and a porter will transfer you there. The procedure is performed under local anaesthetic and should take 60- 90 minutes. If desired sedation can be administered to help you relax during the procedure.

The pacemaker is normally implanted on the left-hand side of your chest just below the collar bone. A small pocket is made under the skin for the pacemaker battery.
 
The pacemaker leads are inserted into your heart by way of the vein under your collar bone. To do this a needle is first placed into the vein.

The pacemaker leads are connected to the generator and the generator is placed in the pocket under the skin.

The pacemaker is tested to ensure that it is working properly and the skin closed with glue. The stitches used are dissolvable and will not need to be removed.

After insertion your pacemaker will be checked that it’s functioning normally and you’ll have an ECG recorded. You’ll be able to go home later that day. If you have had sedation then you should have someone with you overnight following the procedure.

What are the risks of the procedure?

Most pacemaker implantations are uncomplicated, however, there are some risks of which you need to be aware:

• Bleeding occasionally occurs around the pacemaker site
• Infection occurs in 1 in 100 patients
• Pneumothorax (collapsed lung) occurs in 1 in 100 patients
• The pacemaker leads may move following the operation requiring a further operation. This occurs in 1 in 100 patients
• There is a very small risk of causing a small leak of blood around your heart or a serious disturbance of your heart rhythm. Should either of these happen the doctor carrying out the procedure will be able to treat you immediately
• The risk of experiencing serious harm from the procedure is very small indeed

The doctor carrying out the procedure will discuss these risks with you when you are admitted and any questions you have will be answered.

Care of the pacemaker wound

You may experience some discomfort around the wound for the first few days; this can be relieved with simple painkillers e.g. paracetamol. There may also be some bruising.

Please check the wound daily for the first 10 days. If you notice any redness, swelling or discharge from the wound contact the pacemaker clinic on 0161 206 4726/4748 for further advice.

Are there any alternatives?

As no drug therapies are as effective as having a pacemaker there are currently no alternative treatments and your symptoms may be very hard to control without pacemaker insertion.

If you still have any doubts about the procedure please feel free to discuss these with your consultant.

The Health Care Unit is a mixed sex ward

As we nurse patients having elective procedures that only require an overnight stay we have permission to run a mixed sex unit. We will preserve your dignity by ensuring that screens are available.

What to bring with you:

• Dressing gown
• Slippers
• Book or magazine
• Your normal medication in original boxes with labels

Please do not bring in large amounts of money or valuables, as the Trust cannot be held responsible for personal items not handed in for safe keeping.

Your instructions for medication prior to admission

Anticoagulation

You'll be advised by letter whether you need to stop this medication prior to your procedure.

Last Dose:   

Antiplatelet Medication - Clopidrogrel, Plasugrel, Ticagrelor

You'll be advised by letter whether you need to stop this medication prior to your procedure.

Aspirin does not need to be stopped.

Last Dose:    

Please telephone for advice if you are unsure about the instructions provided

TAKE ALL OTHER MEDICATION ON THE DAY OF YOUR PROCEDURE

Will I need to fast for my procedure?

We require that you do not eat anything for 4 hours before your procedure but you can continue drinking clear fluids (water, cordial, black tea/coffee) up to 2 hours prior to your procedure, but then must be nil by mouth.
 
If coming in from home regard the time of your admission as the time of your procedure.

Patients with diabetes

Those patients with diabetes should telephone for advice regarding their medication.

IF YOU FEEL THAT YOUR BLOOD SUGAR IS LOW YOU SHOULD TAKE A SUGARY DRINK OR GLUCOSE TABLETS IMMEDIATELY.

Further information is available from:

The British Heart Foundation
Greater London House, 180 Hampstead Road, London,
NW1 7AW
020 7554 0000
www.bhf.org.uk

Endorsements

Dr Alan Fitchet Cardiology Consultant Amanda Darkin Advanced Practitioner

If you have any concerns about preparing for your pacemaker, contact: 0161 206 5005 or 0161 206 5006