Pacemaker

The following information should help you prepare for the permanent implantation of a pacemaker under local anaesthetic. Any questions or concerns you may have that are not answered here should be addressed to your surgeon.

Preparation

The preparation for the implantation procedure includes:

• No food or liquids for four hours prior to the procedure
• Blood tests to check your potassium and haemoglobin levels
• A full betadine bath (including hair wash) one hour prior to the procedure and
• Male patients will have both sides of their chest shaved, from below the shoulder blades down to the nipple line

Medication

Prior to procedure:

• The use of Warfarin is usually stopped prior to the procedure, as advised by your cardiologist, and a PI blood check is done on admission to establish the clotting level.
• Disprin should not be taken the day before the procedure or on the day of the procedure, to avoid bleeding.
• You may be given a sedative in the ward, or once you are in the cardiac catheterisation laboratory, to relax and calm you.

During procedure

• A venflon (needle) is inserted into the right hand so that medication can be administered during the procedure.
• After procedure
• Prophylactic antibiotics are sometimes prescribed.

Procedure

A temporary pacemaker is occasionally inserted via the right or left groin prior to the implantation of the permanent pacemaker. This is performed under a local anaesthetic so you will remain awake during the procedure.

Care after implantation

• You will be connected to a monitor and observed continuously for proper functioning of the pacemaker.
• Bed rest has to be maintained for 24 to 48 hours after the procedure.
• You will be required to do deep breathing exercises, and passive exercises of the limbs while in bed.
• You should not lift your left hand or move it about during the first 24 to 48 hours after the procedure, as this may cause the lead to move out of position.
• A waterproof dressing is applied a day after the procedure and you will be allowed to shower from the second day.
• Your pacemaker will be checked by a technologist before you are discharged. The technologist will also hand you a booklet on living with your pacemaker.

Follow-up visits

The sutures should be removed by your doctor or at a hospital or clinic one week after the procedure. Remember to book a follow-up appointment with your doctor for six weeks after discharge. The functioning of your pacemaker will be tested at this time. If, however, you feel unwell before this time you should contact your cardiologist immediately.