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Cardiac Pacemakers

A pacemaker is a device which is designed to replace the function of the native electrical system of the heart. Sometimes damage from a heart attack can cause the “wires” in the heart one is born with to have problems. The heart beat may pause or stop altogether intermittently causing bothersome symptoms. In other patients, those wires simply wear out overtime and a pacemaker is needed to tell your heart muscle when to beat. There are typically two parts – a pulse generator which is the “brains” of the pacemaker, and leads or “wires”, which extend from the generator into the heart. The pacemaker generator sits in a small pocket under the skin created in a simple surgical procedure.

HOW IS A PACEMAKER INSERTED INTO THE HEART?
  • A pacemaker will be placed during a minor surgical procedure where a small incision about 2 inches wide is made in the upper chest under the collar bone.
  • A small “pocket” is made under the skin but on top of the chest muscle where the pacemaker pulse generator will be inserted.
  • One or two leads or “wires” will then be threaded through the vein under the collar bone which leads to the heart chambers where the wires will be attached. The wires are connected to the pulse generator under the skin and the pocket is sewn together.
  • An X-ray camera is used to show the cardiologist when the pacemaker wires are in the appropriate place in the heart and a computer which communicates with the pacemaker can verify the device is working well.
WILL I BE ASLEEP?

Much like a heart catheterization, the goal is to achieve “moderate sedation” where the patient is very relaxed but not “all the way out”. If you are uncomfortable during any portion of your procedure let the nurse know so that additional medicine to help you get comfortable can be given.

CAN I GO HOME THE SAME DAY?
  • If this is the first time you are having a pacemaker inserted you will need to spend a night in the hospital and if all goes well you will be discharged the following day usually.
  • If you are having a battery changed out in a pacemaker that was placed some time ago, you can typically go home the same day after a few hours in recovery.