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Outline of man's chest showing pacemaker in chest with leads going into heart chambers.

A pacemaker is a small electronic device that keeps your heart beating at the right pace. Inserting the pacemaker into your body is called implantation.

How do I get ready for a pacemaker procedure?

  • Follow any directions you are given for not eating or drinking before surgery.

  • Tell your doctor about any allergies to medicines, shellfish or iodine contrast, tape or adhesives, or antibiotic soaps. Other options can be provided and precautions can be taken to avoid exposing you to anything that you are allergic to.

  • Follow your healthcare provider's instructions on what medicines to take. If you are taking a blood thinning medicines, your healthcare provider may tell you to stop it before the procedure. This is to decrease the risk of major bleeding. You may be told to stop medicines that interact with the contrast dye that is used during the procedure.

  • You may be asked to shower with antibacterial soap the night before your procedure and the morning of the procedure. Ask your provider what kind of soap to use.

  • Your provider may ask you to use clean bed sheets and pajamas the night before the procedure. This can reduce the risk of infection.

  • You may be given an antibiotic through an IV (intravenous) to also protect you from infection after the implant procedure.

  • You will have blood drawn depending on your overall health. If your kidneys are not healthy , special care may be needed before the procedure.

  • If you are a woman of child-bearing age you may be asked to take a pregnancy test before the procedure.

What happens during the procedure?

  • Your doctor may prescribe a medicine to help you relax and to prevent pain during the procedure.

  • An IV line will be placed in the arm on the same side of the procedure site.

  • A local anesthetic is given by injection to numb the area where the pacemaker will be inserted. This keeps you from feeling pain during the procedure.

  • The doctor will make a cut (incision) where the generator is placed.

  • The doctor will guide the wire (lead) through a vein into your heart’s chambers using X-ray monitors.

  • The doctor will attach the pacemaker generator to the lead or leads and test the device

  • The doctor will close the incision site with stitches. He or she may also seal the site with a surgical glue to prevent infection.

  • A dressing may be applied to your incision. This is to reduce the risk of bleeding and protect it from infection.

  • The pacemaker’s settings are programmed to help your heart beat at a rate that’s right for you.

What happens after the procedure?

  • You will have a chest X-ray while you are in the recovery area.

  • Your pacemaker settings will be rechecked.

  • Your provider may prescribe antibiotics to take after the procedure to prevent infection.

  • Follow the instructions you are given for caring for the implantation site. You may be told not to raise the arm on that side for a certain period. You may have a sling to keep you from moving your arm on the incision side. This is done to prevent the new pacemaker wire from becoming displaced. Your doctor will tell you how long and when you should wear this.

  • Take your temperature and check your incision for signs of infection every day for a week.

  • Return for a follow-up visit as advised.

  • As your healthcare provider when it will be safe to shower, bathe, or swim. Generally, you should not soak in water for about a week to prevent the incision from softening, opening, or becoming infected.

  • Don't do any activities that would put pressure on your incision site or cause irritation to the incision. Don't use lotions, powders, or ointments unless your provider says it's OK. Don't carry a purse or backpack that would put pressure on your incision site.

When to call your healthcare provider

Call 911 if you have:

  • Chest pain

  • Severe trouble breathing

Call your healthcare provider right away if you have any of the following:

  • You feel any of the symptoms you had before the pacemaker was implanted. These include dizziness, lightheadedness, lack of energy, or fainting spells.

  • Your chest or abdominal muscles twitch

  • You have hiccups that won't stop

  • You have a rapid or pounding heartbeat or shortness of breath

  • You feel pain in the area around your pacemaker

  • You have a fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Redness, severe swelling, drainage, bleeding, or warmth at the incision site

  • Your incision site is not healing or it separates or opens

  • Your pacemaker generator feels loose or like it is wiggling in the pocket under the skin

  • If you need an MRI for any reason. In some cases, it's not safe to have an MRI with a pacemaker.

Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Steven Kang MD
Date Last Reviewed: 5/1/2019
© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.