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Pacemaker or ICD Replacement: Before Your Surgery

Inside view of heart in chest, with placement of pacemaker or ICD nearby and lead from device through blood vessel to inside of heart

What is it?

Pacemakers and implantable cardioverter-defibrillators (ICDs) are battery-powered devices that are implanted in the body to treat heart rhythm problems. Your device is placed just beneath the skin of your chest. Wires (called leads) connect the device to your heart. When the battery runs down, or if the device isn't working well, the device will need to be replaced.

The leads can be left in place and reconnected to your new device. But if your doctor thinks you need new leads, he or she can replace them at the same time.

You will get medicine before the procedure. This helps you relax and helps prevent pain. You may also get an antibiotic to help prevent infection. The doctor will make a cut in the skin next to your device. He or she will remove the device and put a new one in its place. The doctor will then attach the leads to the device. The cut will be closed with stitches, tape, or a special glue.

The procedure usually takes about an hour. You may go home the same day. If the leads were replaced, you may need to spend the night in the hospital.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

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

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • 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 surgery may take about 1 hour. It may take longer if the leads are replaced.

When should you call your doctor?

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

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.