Preparing for the procedure

• Do not eat or drink anything after midnight the night before your procedure. Morning medications may be taken with sips of water.
• Insulin-dependent diabetics should adjust their insulin dose accordingly.
• Oral diabetic medications should be held the morning of the procedure.

What to expect

Implantation of a pacemaker is a relatively minor surgical procedure that is performed using local anesthesia. It takes about 60-90 minutes. If you are not in the hospital already, you will be admitted the morning of or evening before your pacemaker implantation. You should not eat or drink anything after midnight. Your heart is monitored before, during, and after implantation. An intravenous (IV) catheter is inserted in an arm for administration of fluids and medications.

Your chest is cleaned with a special antibacterial soap and shaved if necessary. A special X-ray machine is positioned over you to help your doctor correctly place the pacemaker lead wires. The area of the incision, just below the collarbone, is numbed with a local anesthetic, and additional medication may be given through the IV to help you relax.

The doctor inserts the lead wires into a vein under the collarbone, and threads them, under x-ray guidance, into the right side of the heart. They are then attached to the pulse generator, which is then place beneath the skin of the chest wall. The skin is sutured closed, the area bandaged, and you are taken back to your room.

You may then eat regular meals. Be careful not lift your arm (which is on the side of your pacemaker) above your shoulder. You will spend the night in the hospital, and x-rays of the chest will be taken that day and the following morning.

A follow-up appointment should be made within the next week to check the incision site and the pacemaker. Keep the pacemaker incision site clean and dry until the appointment. Avoid raising the arm on the side of the pacemaker above your shoulder and avoid lifting objects over two pounds on that side for two weeks. Activities like tennis and golf should likewise be avoided for about 2-4 weeks, to allow the pacemaker incision and lead to heal completely. Resume your regular medications, unless specifically instructed otherwise by your physician.