Pacemaker Clinic

Who Needs a Pacemaker?

You may need a pacemaker implantation if you experience:

• Slow heart rate (bradycardia)
• Recurrent fainting (syncope)
• Frequent dizziness or light-headedness due to irregular heart rhythm
• Shortness of breath (dyspnea) related to heart problems

Types of Pacemakers

Pacemakers connect to the heart using thin wires called leads. Depending on your condition, one or two leads may be required.

1. Transvenous Pacemaker

• Most commonly used type
• Implanted under the skin or muscle of the upper chest
• Leads pass through a vein into the heart

2. Epicardial Pacemaker

• Implanted under the skin of the chest or abdomen
• Leads are attached to the outside of the heart
• Usually used in specific medical situations

Before Pacemaker Implantation

Important Information to Share With Your Doctor

Tell your healthcare provider if you have:

• Any allergies
• Current medications (including supplements and herbal products)
• History of reactions to anaesthesia
• Blood or bone disorders
• Previous surgeries or chronic medical conditions
• Pregnancy or possible pregnancy

Risks of Pacemaker Implantation

Pacemaker implantation is generally safe, but possible risks include:

• Infection
• Bleeding or bruising
• Pacemaker or lead malfunction
• Lung collapse (pneumothorax)
• Blood clots
• Heart or blood vessel injury
• Allergic reactions to medications
• Infection of the heart lining (endocarditis)

Your doctor will discuss these risks with you in detail.

Preparation Before the Procedure

Eating & Drinking Guidelines

• 8 hours before: Stop heavy meals (fried or fatty foods)
• 6 hours before: Stop light meals and milk products
• 2 hours before: Stop all clear liquids

Medications

• Ask about stopping or adjusting blood thinners, diabetes medicines, or NSAIDs
• Do not take aspirin unless instructed
• Inform your doctor about all supplements and over-the-counter medicines

Tests Before Surgery

You may undergo:

• ECG (Electrocardiogram)
• Chest X-ray
• Echocardiogram
• Heart rhythm monitoring
• Blood tests
• Genetic testing (if required)

General Instructions

• Avoid smoking or nicotine products for at least 4 weeks
• Follow infection-prevention instructions
• Arrange transportation home
• Have someone stay with you for 24 hours after discharge

During the Pacemaker Implantation Procedure

• An IV line will be placed
• You may receive local anaesthesia, sedation, or general anaesthesia
• The pacemaker and leads are inserted based on the selected type
• Imaging (fluoroscopy) is used to guide lead placement
• The device is tested before closing the incision
• Incisions are closed with sutures, adhesive strips, or skin glue

The procedure typically takes 1–2 hours.

After the Procedure (Hospital Care)

After pacemaker implantation:

• Vital signs are closely monitored
• ECG and chest X-ray are performed
• Pain relief and antibiotics may be given
• The pacemaker is programmed
• You will receive a pacemaker ID card

Pacemaker Implantation – Aftercare & Recovery

What to Expect After Surgery

It is normal to experience:

• Mild pain or soreness
• Swelling or bruising near the incision
• A small visible or palpable bump where the device isplaced

Home Care Instructions

Medications

• Take medicines exactly as prescribed
• Complete all antibiotics
• Ask if medications affect driving or work

Incision Care

• Keep the dressing intact until advised
• Do not apply creams or ointments near the incision
• Keep the area clean and dry for 2–3 days
• Avoid bathing, swimming, or hot tubs for 7–10 days
• Monitor daily for signs of infection

Activity Restrictions

• Avoid driving until approved by your doctor
• Do not lift objects heavier than 4.5 kg (10 lb)
• Avoid lifting your arm above shoulder level for 6 weeks
• Avoid strenuous arm movements (golf, swimming, tennis)
• Return to work only when cleared by your healthcare provider

Pacemaker & Electrical Safety

Avoid strong electromagnetic fields such as:

• Airport security scanners (carry your pacemaker ID)
• Large generators or power plants
• Welding equipment

Safe tips:

• Hold mobile phones on the opposite side of the pacemaker
• Keep electronic devices at least 30 cm (1 foot) away

Long-Term Pacemaker Care

• Attend regular follow-up appointments
• Use remote monitoring if instructed
• Inform all healthcare providers (including dentists)
• Wear a medical alert bracelet
• Pacemaker batteries last 5–15 years and are replaced when needed

When to Contact Your Doctor

Call your healthcare provider if you experience:

• Sudden weight gain
• Swelling in legs or feet
• Heart palpitations
• Signs of infection
• Fever or chills

Get Emergency Help If You Have:

• Chest pain
• Severe shortness of breath
• Fainting or extreme fatigue