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Pacemaker Placement for Heart Failure: Before Your Procedure

What is pacemaker placement for heart failure?

A pacemaker for heart failure is a biventricular pacemaker (say "by-ven-TRICK-yuh-ler"). Treatment that uses this type of pacemaker is called cardiac resynchronization therapy (CRT).

When you have heart failure, the lower chambers of your heart may not pump at the same time. The pacemaker sends painless electrical signals to your heart. These signals make the chambers pump at the same time. This can help your heart pump blood better and help you feel better.

Your pacemaker may be combined with an ICD, or implantable cardioverter-defibrillator. It can control abnormal heart rhythms. This can prevent sudden death.

You will get medicine to help you relax and prevent pain. The doctor will make a cut in the skin just below your collarbone. The cut may be on either side of your chest. The doctor will put the pacemaker leads through the cut. The leads go into a large blood vessel in the upper chest. Then the doctor will guide the leads through the blood vessel into different chambers of the heart. The doctor will place the pacemaker under the skin of your chest. He or she will attach the leads to the pacemaker. Then the cut will be closed with stitches.

The procedure usually takes 2 to 3 hours. You may need to spend the night in the hospital.

Pacemaker batteries usually last 5 to 15 years. Your doctor will tell you how often you will need to have your pacemaker and battery checked.

You can likely return to many of your normal activities after your procedure.

You may feel worried about having a pacemaker. This is common. You might feel better if you learn ways to relax. And it can help if you learn about how the pacemaker helps your heart. Talk to your doctor about your concerns.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Preparing for the procedure

  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before the procedure. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take 2 to 3 hours.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your procedure. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.