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Pacemaker

Treatment Overview

A pacemaker is a small device. It sends out mild electrical signals that keep your heart beating normally. The signals are painless. It can help stop the dizziness, fainting, and shortness of breath caused by a slow or unsteady heartbeat.

A pacemaker is powered by batteries. Most pacemakers are placed under the skin of your chest. They have thin wires, called leads. The leads pass through a vein into your heart.

A pacemaker can help restore a normal heart rate. It is used when certain problems have damaged the heart's electrical system, which normally keeps your heart beating steadily.

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 about your concerns.

What To Expect

Most people stay overnight in the hospital after having a pacemaker implanted and typically go home the next day. But sometimes, the surgery is done as an outpatient procedure, which means you do not need to stay overnight in the hospital.

You can likely return to normal activities after a few weeks. For several weeks after the surgery, you should avoid vigorous physical activity that involves your upper body.

You'll need to use certain electric devices with caution. Some devices have a strong electromagnetic field. This field can keep your pacemaker from working right for a short time. These devices include things in your home, garage, or workplace. Check with your doctor about what you need to avoid and what you need to keep a short distance away from your pacemaker. Many household and office electronics don't affect your pacemaker.

Your doctor will check your pacemaker regularly. Your doctor may adjust it, if needed. In between checkups at your doctor's office, you will probably send information from your pacemaker to your doctor. You may do this online or over the phone.

Permanent pacemakers are powered by batteries. The batteries usually last 5 to 15 years before they need to be replaced.

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Why It Is Done

Your doctor might recommend that you get a pacemaker if:

  • You have a problem with your heart rhythm that could be helped by a pacemaker.
  • You have trouble doing everyday activities, or you can't do them at all.

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How Well It Works

Pacemakers stimulate the heart to speed up when it beats too slowly. They can also substitute for the natural pacemaker of the heart (SA node) or the heart tissue that regulates the beating of the ventricles (AV node).

Pacemakers allow people to return to normal, active lives. Most people have very few limitations, if any.

Risks

There are several risks to getting a pacemaker. But risks vary for each person. And risks vary based on the type of pacemaker you get. The chance of most problems is low.

The procedure to implant a pacemaker is safe and most people do well afterward. Afterward, you will see your doctor regularly to check your pacemaker and make sure you don't have any problems.

During the procedure

If problems happen during the procedure, doctors can likely fix them right away. Examples include:

  • A lung could collapse (pneumothorax). This happens if air builds up in the space between the lung and the chest wall. But a pneumothorax can be treated and people recover well. This problem may happen about 1 to 5 times out of a 100.footnote 1
  • A tear in the heart could happen. Or a person might need emergency medicine or surgery. Based on rates of complications from patients, these problems happen about 1 time out of 100. So about 99 times out of 100, these problems do not happen.footnote 2

After the procedure

Problems after the procedure can be minor, like mild pain, or serious, like an infection. But your doctor can solve most of these problems. And most people do not have long-term issues with their pacemakers.

Problems include:

  • Pain, bleeding, or bruising soon after the procedure.
  • Blood clots in your arms, which cause a lot of swelling.
  • Infection in your chest near the pacemaker. An infection might happen about 1 time out of 100. This means that about 99 times out of 100 there is no infection.footnote 2
  • Device problems that need another procedure to fix them. For example, this might happen if a pacemaker lead breaks or a lead moves out of place.

References

Citations

  1. Res JCJ, et al. (2004). Pneumothorax resulting from subclavian puncture: A complication of permanent pacemaker lead implantation. Netherlands Heart Journal, 12(3): 101–105.
  2. Baddour LM, et al. (2010). Update on cardiovascular implantable electronic device infections and their management. A scientific statement from the American Heart Association. Circulation, 121(3): 458–477.

Credits

Current as of: April 29, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
John M. Miller MD, FACC - Cardiology, Electrophysiology