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Leadless Pacemaker Placement: Before Your Procedure

Catheter moves through blood vessel from groin to heart's right ventricle, with detail of right ventricle

What is leadless pacemaker placement?

A leadless pacemaker is a small, battery-powered device. It sends mild electrical signals to your heart to keep it beating normally. These signals are painless. The pacemaker can help stop the dizziness, fainting, and shortness of breath caused by a slow heart rate.

You will get medicine before the procedure. It helps you relax and helps prevent pain.

Your doctor doesn't need to make any cuts to do the procedure. Instead, he or she uses a thin tube called a catheter. The pacemaker is placed inside the catheter. The doctor puts the catheter into a blood vessel in your groin. You will get a shot to numb the skin where the catheter goes in.

Then the doctor moves the catheter through the blood vessel to your heart. You may feel pressure when the doctor does this. Your doctor may also have injected a dye into your blood vessel and heart. The dye shows up on a screen. It helps your doctor see where to move the catheter and pacemaker.

When the catheter is inside the lower right chamber of the heart (right ventricle), the doctor moves the pacemaker out of the catheter. He or she attaches the pacemaker to the heart tissue so that it doesn't move. Flexible hooks may be used. Then the catheter is removed from your body.

Most people spend the night in the hospital. Your groin may have a bruise and feel sore for a day or two.

You may feel worried about having a pacemaker. This is common. It can help if you learn about how the pacemaker helps your heart. Talk to your doctor if you have concerns.

What happens before the 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.

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 it before your 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. 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.

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.
  • Follow your doctor's instructions about when to bathe or shower before 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.
  • Leave your valuables at home.

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.
  • After the procedure, pressure will be applied to the area where the catheter was put into your blood vessel. Then the area may be covered with a bandage or a compression device. This will prevent bleeding.
  • Nurses will check your heart rate and blood pressure. The nurse also will check the catheter site for bleeding.
  • You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.
  • You will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to keep it still.
  • The procedure will take about 30 to 40 minutes.

Going home

  • 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.
  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • Some people spend the night in the hospital. It is also possible for you to go home that same day.

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 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.

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