What Is a Pacemaker?
Pacemakers are used to treat heart rhythms that are too slow. These abnormal
heart rhythms are called arrhythmias. The healthy heart has its own pacemaker
that regulates how fast the heart beats. Normally, the two upper chambers
of the heart (right and left atria) and two lower chambers (right and
left ventricles) work together to pump blood through the heart. The electrical
system of the heart is the power source that makes this possible.
However, some hearts don’t beat regularly because the normal electrical
pathway has been interrupted. Often, a pacemaker can correct the problem.
A pacemaker is a small device that sends electrical impulses to the heart
muscle to contract to maintain a suitable heart rate and rhythm.
Types of Pacemakers
There are two types of pacemakers. Your doctor will discuss what type is
best suited for you.
Single Chamber: A lead is attached in the right ventricle (RV) and energy is delivered
to the right ventricle to help it contract.
Dual Chamber: Leads are attached in the right atrium (RA) and right ventricle (RV).
Energy is delivered first to your right atrium and then to your right
ventricle to help your heart beat in a normal sequence.
Before the Procedure
Should I take my medications?
Prior to the procedure, your doctor will discuss with you what medications
to continue taking or what medications to stop.
Can I eat before the procedure?
You will not be able to eat or drink anything after midnight before your
procedure. If you must take medications, you will be instructed to take
them with a very small sip of water. When brushing your teeth, do not
swallow any water.
Where does the procedure take place?
You will be instructed on what time to arrive and where to arrive the
day of your procedure. You can call the office at (408) 879-5900 if you
have any questions.
What can you expect during the procedure?
The procedure typically takes 1 to 2 hours. The pacemaker is implanted
with numbing medication injected into the surgical site as well as intravenous
pain and relaxation medication administered by a nurse. Flexible insulated
wires (leads) are inserted into a vein under or near your collarbone,
typically on the left side. The leads are guided with the help of X-ray
images to the proper chamber of your heart: either the right atrium or
right ventricle. The other end of the lead is attached to the generator
which is implanted in a pocket under the skin in the upper chest. Your
new device and new lead(s) will be tested after they are properly implanted.
What to expect after the procedure?
After implant, you may have some discomfort around the incision area, which
can remain tender and swollen for a few days or weeks. Pain medication
will be provided by your physician so that you have adequate pain relief.
You will stay in the hospital overnight. Your device will be re-evaluated
the morning after implant and, if everything is stable, you will be discharged
home. You will receive specific instructions about how to care for yourself
after the procedure including medication guidelines, wound care, activity
guidelines, and device care and maintenance.
What happens after I go home?
You will be periodically followed in our Arrhythmia Device Clinic. You
will be given follow-up instructions prior to discharge.
Pacemaker therapy is only one part of a comprehensive treatment program.
It is important that you continue to take your medications, make dietary
changes, live a healthy lifestyle and keep your follow up appointments.
We want you to be an active member of your treatment team.