CARDIAC PACEMAKERS WHAT MY PATIENTS NEED TO KNOW BEFORE
IMPLANT

What is a pacemaker and how it works?

A small device implanted under the skin, designed to
mimic the heart’s natural pacemaker

When the heart natural” battery” becomes depleted, the
artificial pacemaker is implanted to take over.

A Pacemaker has two purposes

• Pacing-
  sending an impulse when your own heart rhythm is too slow,” taking over
  your heart” when needed
• Sensing-
  or” monitoring” your heart activity; when you have a normal heartbeat,
  will not deliver an impulse

A Normal Sinus Beat

B Longer pause, Pacemaker senses and takes over

C Pacemaker delivers the impulse

What I tell my patients before implant

• The
  Pacemaker won’t prolong your life; will make it safer – no falls, passing
  out
• The
  Pacemaker improves quality of life; more energy, better stamina
• Won’t
  correct Atrial Fibrillation; you will still need to take the blood
  thinners!
• Your
  lifestyle won’t change after Pacemaker; will be better by increasing the
  level of activity.

When do you need a Pacemaker?

• Slower
  pulse than normal (bradycardia) or pauses > 3 sec
• Fainting,
  Dizziness, Fatigue, Chest pain, Shortness of breath,
• Palpitations,
  Decreased stamina

The day before implant

My office will advise you

• Hold
  blood thinners: 3 days for Eliquis, Xarelto or Pradaxa; Coumadin will be
  held to decrease the INR to less than 1.5
• Hold
  metformin for 2 days. If you take insulin, hold the morning dose.

• The
  hospital will call you the night before regarding time of surgery
• No
  eating or drinking after midnight the night before surgery. Take your
  pills ( except blood thinners and metformin) in the morning with a few
  sips of water.
•  Clean
  your entire chest with Hibiclens Antiseptic Cleanser the evening before
  procedure and again the morning of procedure; Hibiclens can be found over
  the counter at any pharmacy
• If
  allergic to iodine, follow my office protocol

How do I implant the pacemaker?

• The
  surgery lasts about 1-2 hours
• You’ll
  receive a sedative but no general anesthesia; you may be awake during
  surgery, but will not feel any pain
• I
  will make a small incision under the collarbone, and I’ll pass a wire
  through it into your veins, guiding it to your heart. The procedure is
  performed under X ray guidance
• Over
  the guiding wire, I will advance the pacemaker lead to your Right
  ventricle, attaching the tip to the heart muscle. Using a different wire,
  I will advance and attach the second lead to your Right atrium.
• The
  proximal end of the leads is attached to the Generator,” the battery of pacemaker”,
  positioned under your skin

Every invasive procedure may result in complications.

• Infections
  at implant site
• Allergy
  to the dye or anesthesia
• Bruising,
  Bleeding at incision, if on blood thinners
• Collapsed
  lung- rare
• Heart
  Perforation- rare
• Lead
  dislodgement with second procedure needed for reinsertion

Many people initially feel their lack of energy or shortness
of breath is normal and due to their aging process.

After the Pacemaker implant many are surprised that their old
zippety do da is back.