Pacemakers are placed in a patient’s chest to increase his or her heart rate. A patient is scrubbed and draped, and IV sedation is given, which makes the patient comfortable, but not completely asleep. The cardiologist will numb up the chest under the collarbone (usually on the left, if the patient is right-handed) and make a small incision. A small pocket is made in the chest wall to hold the pacemaker generator, and then the doctor threads leads through the incision into a large blood vessel and into the heart. The leads are connected to the generator (pacemaker unit), and placed into the pocket. The wound is closed, using sutures, which eventually dissolve. A Pacemaker patient will usually stay the night at TMCA for monitoring, with his or her affected arm in a sling, to prevent movement of the leads. He is also asked not to lift the affected arm above his head for 2-4 weeks after the procedure and to keep his or her dressing clean and dry for 3 days following the procedure, after which he can remove it.
Pacemakers that we use come from one of several companies, and the representative from that company will be present before, during and after the procedure. The doctor and the representative will be able to answer questions a patient may have about the particular unit chosen for him. The representative will provide the patient with a temporary ID card, and later the patient will be sent a permanent ID card from the company.
Preparation for a pacemaker involves not eating or drinking for at least 6 hours before the procedure, except that a patient may take some of his morning pills with a sip of water. Some blood thinners are stopped for this a few days in advance. You will be given instructions about your medicines by phone. We ask Pacemaker patients to check in at TMCA in the Surgery Waiting Room (by the gift shop) 2 hours before the procedure start time.