Pacemaker Placement: What to Expect at Home

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Your Recovery

Location of pacemaker in upper-left chest, showing its lead through subclavian vein and into right ventricle

Pacemaker placement is surgery to put a pacemaker in your chest. A pacemaker is a small, battery-powered device that sends electrical signals to the heart to keep the heartbeat steady. Thin wires, called leads, carry the signals from the pacemaker to the heart. A pacemaker can prevent or reduce dizziness, fainting, and shortness of breath caused by a slow or unsteady heartbeat.

Your chest may be sore where the doctor made the cut (incision) and put in the pacemaker. You also may have a bruise and mild swelling. These symptoms usually get better in 1 to 2 weeks. You may feel a hard ridge along the incision. This usually gets softer in the months after surgery. You may be able to see or feel the outline of the pacemaker under your skin.

You will probably be able to go back to work or your usual routine 1 to 2 weeks after surgery.

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

When you have a pacemaker, it is important to avoid electrical devices that can stop your pacemaker from working right. Check with your doctor about what you need to stay away from, what you need to use with care, and what is okay to use. You will need to stay away from things with strong magnetic and electrical fields such as an MRI machine (unless your pacemaker is safe for an MRI), welding equipment, and power generators. You can use a cell phone, but keep it at least 15 centimetres away from your pacemaker. You can safely use most household and office electronics such as kitchen appliances, electric power tools, and computers.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • For 4 to 6 weeks:
    • Avoid activities that strain your chest or upper arm muscles. This includes pushing a lawn mower or vacuum, mopping floors, swimming, or swinging a golf club or tennis racquet.
    • Do not raise your arm, on the side of your body where the pacemaker is located, above your shoulder.
    • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or heavy aerobic exercise.
    • Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a child.
  • Ask your doctor when you can drive again.
  • You will probably need to take about 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other non-steroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • Keep the incision dry while it heals. Your doctor may recommend sponge baths for about 7 days but do not get the incision wet. Your doctor will let you know when you may take showers. After a shower, pat the incision dry.
  • Don't use hydrogen peroxide or alcohol on the incision, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Do not take a bath or get into a hot tub for the first 2 weeks, or until your doctor tells you it is okay.

Other instructions

  • Keep a medical ID card with you at all times that says you have a pacemaker. The card should include the manufacturer and model information.
  • Wear medical alert jewellery that states you have a pacemaker.
  • Check your pulse as directed by your doctor.
  • Have your pacemaker checked as often as your doctor recommends. In some cases, this may be done over the phone or the Internet. Your doctor will give you instructions about how to do this.

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.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest..
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Light-headedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.

Call your doctor or nurse call line now or seek immediate medical care if:

  • Your heartbeat feels very fast or slow, skips beats, or flutters.
  • You are dizzy or light-headed, or you feel like you may faint.
  • You have new or increased shortness of breath.
  • You have pain that does not get better after you take pain medicine.
  • You hear an alarm or feel a vibration from your pacemaker.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have signs of a blood clot, such as:
    • Pain in your arm on the same side that the pacemaker is placed, or in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your arm on the same side that the pacemaker is placed, or in your leg or groin.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have any problems with your pacemaker.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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