What is a Permanent Pacemaker?

A pacemaker is a small device implanted under the skin, usually below the collarbone, to help regulate your heart rhythm. It consists of:

• A pulse generator (battery and electronic circuit)

• One or more leads (wires) that connect to your heart

Pacemakers are used to treat slow heart rhythms (bradycardia) and other conduction abnormalities.

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Why Do I Need a Pacemaker?

You may need a pacemaker if you experience:

• Slow heart rate causing dizziness, fainting, or fatigue

• Heart block (delay in electrical signals reaching the heart muscle)

• Certain conditions like sick sinus syndrome or after heart surgery​

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Before the Procedure

• You may need blood tests, an ECG, and echocardiography. Sometimes more specialist tests of the heart are required such as CT scans or MRI scan.

• Inform your doctor about any medications, allergies, or medical conditions.

• You may be asked to stop certain medications (e.g., blood thinners) before the procedure.

• Do not eat or drink for a 4 hours before the procedure. Small sips of water are allowed unto 2 hours before the procedure.

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How is the Pacemaker Implanted?

1. The procedure is done under local anaesthesia with sedation and performed in a cardiology catheter laboratory (similar to an operating theatre but designed for specialist procedures performed by cardiologists)

2. A small incision is made below the collarbone.

3. The leads are inserted into a vein and guided to your heart using X-ray imaging.

4. The pacemaker is connected to the leads and placed under the skin.

5. The incision is closed with absorbable stitches, Steri-Strips and a dressing attached to the skin.

The procedure usually takes 1–2 hours.

 

Risks and complications from the procedure

Fortunately risk of the pacemaker procedure are rare but they include; bleeding, infection collapsed lung, displaced leads, lead perforation, reaction to drugs.

Your cardiologist will manage any immediate complications.

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After the Procedure

• You may stay in the hospital for a few hours or overnight for monitoring.

• Your pacemaker will be checked before discharge.

• You will have a chest Xray to check the position of the leads and check for complications such as a collapsed lung.

• Mild discomfort, swelling, or bruising at the implant site is normal.

• Avoid lifting the arm on the side of the pacemaker above shoulder height for 4–6 weeks.

• Avoid any heavy lifting for at least 4 weeks after the implant.

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Living with a Pacemaker

1. Regular Checks: Your pacemaker will need periodic checks

2. Battery Life: The battery typically lasts 7–15 years, after which it can be replaced, with a further minor procedure

3. Activity: Most daily activities are safe. Avoid contact sports that could damage the pacemaker.

4. Medical Procedures: Inform healthcare providers that you have a pacemaker before undergoing MRI scans or surgery.

5. Electronic Devices: Keep mobile phones and electrical devices at least 15 cm away from the pacemaker.

6. When travelling through security gates at airports please inform the security team that you have a pacemaker and they will arrange appropriate security check rather than passing through conventional metal detectors.

7. Do not stand next to security gates in shops exits

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When to Seek Medical Attention

• Persistent pain, redness, swelling, or discharge at the implant site

• Dizziness, fainting, or unusual fatigue

• Fast or irregular heartbeats

• Unexpected breathlessness or chest pain

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Follow-Up Appointments

You will have a follow-up appointment at 2 and then 6 weeks and then regular checks every 6–12 months.

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Useful websites:

https://api.heartrhythmalliance.org/files/download/0659ebac5f9f6cec286ccfb6c3c2f34d