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.