Pacemaker - Cardiovascular Associates of Maryland

What is a Pacemaker?

You Cardiologist/Electrophysiologist may have recommended a pacemaker.  These devices are most commonly inserted in patients with slow heart rates, a condition called bradycardia. 

Pacemakers:

• Consist of a generator and one, two or three leads to pace the heart.
• The generator houses the battery and electrical components of the device.
• Are relatively small devices.  Approximately 1-2” in diameter and ¼” thick.

Bradycardia 

Bradycardia (or “slow heart rate”) may be a result of high blood pressure (hypertension), hardening of the arteries (coronary artery disease), congenital, or secondary to various medications (beta-blockers, digoxin, calcium channel blockers, anti-arrhythmic drugs).  

Tachycardia/Bradycardia Syndrome 

Tachycardia/bradycardia syndrome is a condition when the heart sometimes beats much too fast (tachycardia) and other times too slow (bradycardia) and is a common reason for pacemaker implantation. This many times accompanies the heart rhythm called atrial fibrillation. By placing a pacemaker that prevents the heart rate from getting too slow, medications can be added to treat the fast heart rates. This creates a “floor” and  “ceiling” on the heart rate preventing the lightheadedness caused by slow heart rates and rapid heart rate sensation of high heart rates.

Implantation

Implanting a pacemaker requires a 1-2 inch incision. Surgery takes approximately 90 minutes and there is only a 1-2% risk of complications. Patients will have an overnight stay.

Anesthesia includes local and conscious sedation (twilight). The leads are threaded via the subclavian/axillary/cephalic vein to the heart.

After Surgery

After a pacemaker is installed the dressing should remain on for up to four days. You can shower once the dressing is removed, but tub bath or sponge bath until then. No lifting the affected side above the shoulder for one month and no lifting greater than five pounds with the affected side for one month.

Daily Living with a Pacemaker

We encourage patients to be very active once the pacemaker has healed. You should:

• Carry the pacemaker ID card with you at all times.
• Inform any medical professional that you have a pacemaker.
• Inform security when walking through a metal detector that you have a pacemaker.  Walking through the metal detector will not harm the pacemaker.

Most pacemakers are not compatible with MRI scanners.  You may have X-rays, CT scans and stress tests. You may also use a microwave with a pacemaker.

Follow-up

Pacemakers are followed either in our clinic or your cardiologist clinic every 6 months. Most pacemakers last 6-8 years, however actual longevity may vary based on pacemaker usage.