Pacemakers
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Pacemakers

Pacemakers

A pacemaker is a small device that is placed inside the body to cause the heart to beat. The pacemaker, also called a pulse generator, does for the heart what the heart’s electrical system cannot do on its own. The pacemaker contains circuits that time how often electrical signals are sent to your heart, causing it to beat. If your heart starts its own beat early enough, these same wires carry the signal back to the pacemaker.

A pacemaker is implanted underneath the skin with leads attached to the heart muscle to regulate the heart’s rhythm. Pacemakers have two parts — a generator which houses the battery and electrical components, and the leads, thin wires that pass through the veins into the heart. The generator sends electrical impulses to the heart through the leads to cause it to beat. The leads also carry information from the heart back to the generator so it can tell when the heart is beating on its own.

What to expect

You are asked not to eat to drink for a number of hours before surgery. Your upper chest will be scrubbed and, if needed, any hair removed. You will be given medicine to help you relax and the skin over the incision will be numbed to prevent any pain.

About one hour of surgery is needed to insert the pacemaker. A permanent pacemaker is placed just under the skin near your shoulder, completely inside your body. A small incision is made in the left upper chest, and a small pocket is made under the skin, but over a vein. Using X-ray technology for guidance, the doctor guides the pacemaker wires through this vein into the heart chambers. When the wires are in place, the pacemaker is attached to them and placed in the pocket under your skin.

After the procedure, most people eat normal foods and are out of bed right away. Many patients have a small bandage over the incision. A nurse will check your pulse, blood pressure and incision. An EEG monitor may be used to see how the pacemaker is working.

The doctor may prescribe several hours of bed rest to ensure that the pacemaker wire is secure within the heart. The area around the incision will be sore for the first day or so. It is common for most patients to go home the next day.

Cardiac monitor (LINQ loop monitor)

An insertable cardiac monitor is a small device that continuously monitors heart rhythms and records them automatically and manually by using a hand-held patient assistant. The device is inserted just beneath the skin in the chest area during a simple procedure. It is the gold standard for determining causes of infrequent, unexplained fainting. An insertable cardiac monitor has the ability to continuously monitor your heart for up to 3 years.

What to expect

On the day of the procedure, you will meet with your implanting physician and review the plans for sedation. Typically, you will receive some intravenous sedatives to relieve any anxiety that you may experience before this short procedure. Thereafter, your chest area, just left of your breastbone, will be cleaned and shaved with an antiseptic solution.

A small incision of ≈1 to 2 cm will be made in this area with creation of a pocket for insertion of the implantable monitor just underneath the skin. On average, the procedure lasts 20 to 30 minutes, and the incision is closed with absorbable sutures.

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