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Pacemaker implantation is a minor surgical procedure in which an electronic device is implanted in the chest to regulate the heart’s rhythm. Generally, pacemakers correct an abnormally slow heartbeat by sending electrical impulses to one or more chambers of the heart. These signals make the heart contract in a more regular rhythm than the chamber would otherwise.
Do not eat or drink anything after midnight the night before the procedure (take your morning pills with sips of water only).

An intravenous catheter (IV) will be started for fluids and medications. There are two methods of pacemaker implantation (we will choose a method depending upon your health, age, and lifestyle):

Endocardial Lead Positioning

The most common pacemaker implantation technique involves advancing the lead, an insulated wire coil, into your heart through a vein while you are under local anesthesia. The tip of the lead rests against the inner lining (endocardium) of the heart. A pulse generator is then implanted under the skin in a specially prepared pocket in the right or left upper chest. You may feel slight pressure while the lead and pulse generator are being inserted. We will observe an X-ray of your heart to ensure proper placement.

Epicardial Lead Positioning

In another implantation procedure, an incision is made in the chest to expose the exterior surface of the heart. The lead is attached directly to your heart’s surface (epicardium). While under local anesthesia, the pulse generator is usually placed beneath the skin in the upper abdomen, but it may also be placed in the upper chest area. Let the staff know immediately if the incision becomes red, hot, more painful, swollen or begins draining fluid.

The procedure will take approximately one hour to complete.

To receive the maximum benefit from your pacemaker, you will need to have regular follow-up to ensure that it is working properly. This follow up can be arranged by you to be performed by your cardiologist or local hospital device clinic (if they have such a clinic), or your follow up can be through our office. This clinic is specially designed to provide follow-up care, evaluation and reprogramming of cardiac devices such as pacemakers, defibrillators, or implantable loop recorders. To contact our office, please call (940) 312-6262 and ask to reach a nurse in the Device Clinic. Our office hours are Monday – Friday, 8:00 A.M. – 5:00 P.M.

The first device evaluation will occur about four months after implantation. A postcard will be mailed to you to remind you to schedule this appointment. You will need to provide the device staff with a list of your current medications, so please bring a copy with you to every visit to our office.

During your first office evaluation, a nurse that is specially trained and certified in evaluating pacemakers and defibrillators will perform a device evaluation called an “interrogation”. During this test, the nurse will utilize a telemetry “wand” to evaluate the pacemaker in a painless manner. This device interrogation will assess if the pacemaker lead wires going into the heart are functioning normally, that the battery level is okay, and will assess if there have been any abnormal heart rhythms detected by the pacemaker. The device nurse will review all the test results with you during your visit and answer any questions you have relating to your pacemaker. After this first pacemaker evaluation, subsequent intensive in-office pacemaker evaluations occur about every six to 12 months.

We recognize that you may have other questions regarding your heart, but since the device nurse is best trained to offer advice regarding your pacemaker system, we suggest that medical care questions be directed to your physician(s).

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