A pacemaker is a small device that helps control your heart rate by: 

• Speeding up the heart rate when it is too slow 
• Slowing down the heart rate when it is too fast 
• Helping the rhythm of the heart beat regularly  – this is if you have a pacemaker combined with a defibrillator, also called an ICD

A pacemaker is placed in the chest during surgery. Wires called leads are put into the heart muscle. The device with the battery is placed under your skin, below your shoulder. When it is time for you to go home after surgery, an adult family member or friend needs to take you home. It is not safe for you to drive or leave alone. Have an adult stay with you at home for the first day after your surgery. Arrive on time for your appointment. The surgery will take 1 to 2 hours.  

To Prepare 

• Talk to your doctor if you take blood thinners or have diabetes. You may need to adjust or change your medicines for some time before the surgery. 
• You may need to shower the evening before and the morning of your surgery with a special soap called CHG (4% chlorhexidine gluconate). It is sold in most pharmacies under the brand name of Hibiclens. Wash from your neck to your waist with this soap the night before your surgery and then again the morning of your surgery. Use 4 ounces (½ cup or 118 ml) of CHG soap each time you shower. 
• Do not eat or drink anything, including water, after midnight before your surgery. 
• Ask your doctor if you should take your medicines the morning of your surgery. If so, take with sips of water. 
• Do not smoke or use any tobacco products for at least 24 hours before your surgery.

During Surgery 

• You will wear a hospital gown. 
• An IV (intravenous) is put in a vein in your arm. Medicines to make you sleepy are given through the IV. 
• Your neck or chest is cleaned. Men may have their chest hair clipped.
• The skin is numbed. 
• The wire leads are put into a vein and guided into your heart using an X-ray. 
• The wire leads are placed in your heart muscle. 
• The other end of each wire is connected to the pacemaker. 
• The pacemaker is placed in a small space under your skin. 
• The incisions are closed with stitches under the skin that will dissolve. You may have narrow pieces of tape across the incisions called steristrips. These hold the skin layer together during healing. These will loosen and fall off in about 10 days. If the tape is not used, special glue may be used to close the incisions.

After Surgery In the Hospital 

• An ice pack may be put on the site. 
• Your blood pressure, heart rate and incisions will be checked often. Your dressing will stay in place for 48 hours after your surgery. 
• The head of your bed is raised. Do not lift your arm over your head on the same side where your pacemaker is placed. 
• If you have discomfort, ask your nurse for pain medicine. 
• You will have a chest x-ray to check your lungs and the pacemaker. 
• Antibiotics are given in your IV to prevent infection. 
• A nurse will explain how your pacemaker works, answer any questions and explain pacemaker checks. 
• Ask your doctor when you can drive or go back to work.     

Your Care At Home 

You will not be able to feel your pacemaker working. You will be able to see and feel the outline of the pacemaker through your skin. 

Incision care 

• Wash your hands well before and after touching your dressing or the incision. 
• Remove the outer dressing 48 hours after your surgery. Do not remove the narrow pieces of tape across the incision. These tapes will loosen and come off on their own in 5 to 10 days. 
• Do not rub the pacemaker site. 
• Do not use lotion or powder on the incisions.  

Bathing 

• Do not take a tub bath or shower for the first 5 days after surgery. The incisions must stay clean and dry. You may take a sponge bath, but do not get the incisions wet. 
• You may shower or bathe on the 6th day but let the water gently run over the incision. Do not let the shower water directly hit the incision, and do not soak the incision under water in the bath. Gently pat the incisions dry with a clean towel. 
• Avoid soaking the incision under water in a bathtub, hot tub or swimming pool until the site is healed, often about 14 days after surgery.

Activity Limits 

• Your doctor may tell you to limit certain activities for 7 to 14 days to allow your pacemaker site to heal. 
• Use your arms but do not lift the arm on the side of the pacemaker above shoulder level. You can raise your arm to wash or comb your hair but avoid raising your elbow above your shoulder on your pacemaker side. 
• Do not push, pull or lift anything heavier than 10 pounds or 4 kilograms. A gallon of milk weighs about 8 pounds. 
• Avoid vigorous exercise, contact sports and activities such as vacuuming, shoveling or washing windows. 

Schedule an appointment with your doctor for follow-up care.

Other Information 

• Tell all your health care providers, including your dentist, that you have a pacemaker. 
• Carry the ID card your doctor gave you. This card has information about your pacemaker. 
• Stay away from large magnets and tools that may generate strong electrical fields, such as car ignition systems and electric arc welders because they may interfere with your pacemaker. 
• Keep items that contain magnets at least 6 inches away from your pacemaker. This includes cell phones, MP3 players, magnetic therapy products, stereo speakers and hand held massagers.

1. Do not place cell phones or MP3 players in shirt pockets over the pacemaker. 
2. Use cell phones on the opposite ear of where your pacemaker is placed. If you strap an MP3 player to your arm, use the arm opposite the pacemaker.  

• It is safe to use household appliances like microwave ovens, computers, toasters, hair dryers and heating pads. 
• You can safely pass through security at airports. Be sure to have your pacemaker ID card with you.

Call to the doctor if you have: 

• A temperature over 100.5 degrees F or 38 degrees C 
• Redness, swelling or drainage around your incisions 
• Tenderness around your pacemaker that gets worse 
• An incision that opens up 
• Swelling or color change to the skin of your arm or hand on the pacemaker side 
• Thumping or jumping feeling in your chest or abdomen  

Get Opinion From Doctor