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Pacemaker Insertion  
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Definition  

This is a procedure to insert an artificial pacemaker. A pacemaker is a small, battery-operated device. It helps maintain a normal heartbeat by sending electrical impulses to the heart.

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Reasons for Procedure  

A pacemaker can be inserted when:

  • The body's natural pacemaker, the sinoatrial (SA) node, is not working properly—this can cause the heart to beat too slowly
  • There are malfunctions in the atrioventricular (AV) node, which is the part of the heart’s electrical system that sends signals from the SA node to the ventricles—this leads to a slow heartbeat
  • Heart performance in people with severe symptoms of congestive heart failure and a weakened heart muscle, known as cardiomyopathy, needs to be improved—his is called biventricular pacing, or cardiac resynchronization therapy
  • Cardiac surgery is being done
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Possible Complications  

Complications are rare, but no procedure is completely free of risk. If you are planning to have a pacemaker inserted, your doctor will review a list of possible complications, which may include:

  • Excess bleeding
  • Infection
  • Pacemaker malfunction
  • Rupture in the heart muscle—rare
  • Inappropriate stimulation of the diaphragm, which is the large muscle between chest and abdominal cavities

Factors that may increase the risk of complications include:

  • Obesity
  • History of smoking
  • History of excess alcohol consumption
  • Bleeding or blood-clotting irregularities
  • Regular use of some medications
  • Chronic disease

Be sure to discuss these risks with your doctor before the procedure.

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What to Expect  

Prior to Procedure  

Before the procedure, your doctor will likely do:

In the days leading up to the procedure:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs such as ibuprofen
    • Blood thinners
    • Anti-platelet medications
  • Eat a light meal the night before the procedure. Do not eat or drink anything after midnight.

Anesthesia  

Local anesthesia will be used. This means that only the area being operated on is numbed. It is given as an injection.

Description of the Procedure  

You will lie flat on a table. Your heart rate, blood pressure, and breathing will be monitored. The doctor will make a small incision beneath your collarbone. The pacemaker will be inserted through this incision. The wires will be threaded through a vein under the collarbone to your heart. Lastly, the incision will be closed with stitches.