Pacemaker insertion discharge instructions (patient information)


 * Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [mailto:msbeih@perfuse.org]

Overview
You had a pacemaker placed in your chest to help your heart beat properly. Most pacemakers have only one or two wires that go to the heart. These wires stimulate the right or left side of the heart when the heartbeat gets too slow. Some pacemakers also can deliver electric shocks to the heart that can stop life-threatening arrhythmias (irregular heartbeats). This is called a "cardioverter defibrillator." You should know what type of pacemaker you have.
 * A small cut was made on your chest below your collarbone. The pacemaker generator was then placed under the skin at this location.
 * Leads (wires) were connected to the pacemaker, and one end of the wires was threaded through a vein into your heart. The skin over where the pacemaker was placed was closed with stitches.

When could I drive after the procedure?
You should not drive after the procedure without asking your doctor when you could do that. This is different for everyone.

What medications should I take after the procedure?
Ask your doctor whether you should go back to taking the medications you were on before the procedure. Be sure your doctor knows about everything you are taking.

Should I take any OTC pain medications?
You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed. Please be sure you are not taking more than one product containing acetaminophen, and do not take more Tylenol than what is recommended on the label.

Wound care
You should be able to do normal activities in 3 - 4 days. For 2 - 3 weeks, do not do these things with the arm on the side of your body where the pacemaker was placed: Do not lift this arm above your shoulder for 6 weeks. Do not wear clothes that rub on the wound for 2 or 3 weeks. Keep your incision completely dry for 4 - 5 days. Afterwards, you may take a shower and then pat it dry. Always wash your hands before touching the wound.
 * Lifting anything heavier than 10 - 15 pounds.
 * Too much pushing, pulling, or twisting.

What precautions should I take?
Most machines and devices will not interfere with your pacemaker. But some with strong magnetic fields may. Always ask your doctor or nurse about any specific device that you need to avoid. Do not put a magnet near your pacemaker. Most appliances in your home are safe to be around. This includes your refrigerator, washer, dryer, toaster, blender, computers and fax machines, hair dryer, stove, CD player, remote controls, and microwave. You should keep several devices at least 12 inches away from the site where the pacemaker is placed under your skin. These include: Tell all health care providers that you have a pacemaker before any tests are done. Some medical equipment may interfere with your pacemaker. Stay away from large motors, generators, and equipment. Do not lean over the open hood of a car that is running. Also stay away from: If you have a cell phone: Be careful around metal detectors and security wands. After any operation, have your doctor check your pacemaker.
 * Battery powered cordless tools (such as screwdrivers and drills).
 * Plug-in power tools (such as drills and table saws).
 * Electric lawn mowers and leaf blowers.
 * Slot machines.
 * Stereo speakers.
 * Radio transmitters and high-voltage power lines.
 * Products that use magnetic therapy, such as some mattresses, pillows, and massagers.
 * Large electrical or gasoline powered appliances.
 * Do not put it in a pocket on the same side of your body as your pacemaker.
 * When using your cell phone, hold it to your ear on the opposite side of your body.
 * Handheld security wands may interfere with your pacemaker. Show your wallet card and ask to be hand searched.
 * Most security gates at airports and stores are okay. But do not stand near these devices for long periods. Your pacemaker may set off alarms.

When may I resume my regular activities?
Do not use your arm on the side where your pacemaker is inserted to lift, push or pull anything weighing more than five pounds, at least for the first 6 weeks. You may do the daily activities like face washing, hair combing, tooth brushing. You should avoid  swimming, playing golf or playing tennis after the procedure.

When can I go back to work?
It depends on the type of your work. You can ask your doctor when you can go back to work.

Follow-up care
You will be informed about your follow-up appointments before leaving the hospital.

When to seek urgent medical care?
Call your doctor if:


 * Your wound looks infected (redness, increased drainage, swelling, painful).
 * You are having the symptoms you had before the pacemaker was implanted.
 * You feel dizzy or short of breath.
 * You have chest pain.
 * You have hiccups that do not go away.
 * You were unconscious for a moment.