Thank you for choosing Rose Medical Center for your cardiac care. Our goal is to make your stay as comfortable and pleasant as possible. Please let our knowledgeable and friendly staff know if there is anything we can do to improve your experience.
What is a pacemaker or defibrillator?
A pacemaker/defibrillator is a small battery-operated device which is placed under your skin near your heart. When your heart is beating too slowly or irregularly, a pacemaker will send a signal to your heart to control your heartbeat. If you have a defibrillator and you experience a life-threatening, rapid heartbeat, it will send an electrical shock to your heart to change the rhythm back to normal. A defibrillator also has pacemaker capabilities as well. One to three leads will be inserted in a vein on the left side of your chest and advanced to the heart wall. The lead(s) will then be connected to a generator and placed in your upper chest.
Why is this procedure being done?
Your doctor may be performing this procedure because you have been diagnosed with an abnormal heart rhythm. Reasons for needing an implantable device include:
- Syncope (unexplained fainting spells)
- Abnormally slow or fast heart beat
- Congestive Heart Failure/ Cardiomyopathy
- Life-threatening heart rhythms such as Ventricular Tachycardia or Ventricular Fibrillation
Before the procedure:
You will be asked not to eat or drink anything after midnight the night before the procedure. Discuss your medications with your doctor, as he or she may want you to stop or adjust the doses several days prior to your procedure. Please bring all your current medications in their original bottles with you on the day of your procedure. Please bring a list of all drug/food allergies, past medical and surgical history also with you. We recommend that you wear comfortable clothing and bring a small bag with your personal items and toiletries in the event you spend the night in the hospital to make your stay as comfortable as possible.
The day before the procedure please let your doctor know if you have any cold or flulike symptoms and/or fever, or if you are having a herpes outbreak. Please shower using antibacterial soap the morning of your procedure and wash your hair. You may also be asked to take an antibiotic to guard against infection. If you have not been prescribed an antibiotic beforehand, you will be given one in the hospital before the procedure.
What to expect upon arrival to the hospital
When you arrive for your procedure, you will be asked to change into a gown. Please remove all undergarments and use the restroom as needed. Please let the staff know if you are taking blood thinners such as aspirin, warfarin, clopidogrel, prasurgel, ticagrelor, rivaroxaban, apixaban and dabigatran etexilate, diuretics (water pills), and/or any form of diabetic medication. An IV will be started so you can receive medications during your procedure and the nurse will review your medical history with you once again. At this time blood work will be drawn if needed and an EKG will be performed.
During the procedure:
The temperature in our catheterization lab is kept cool to prevent damage to our x-ray equipment that is used during your procedure. We will offer you warmed blankets for your comfort. You will be assisted on to a special table for the procedure and then we will begin attaching monitoring equipment to you.
The cardiac cath lab staff will shave and cleanse your chest, while keeping your privacy as our primary concern. A sterile drape will be used to cover the area of the chest where the device will be placed to prevent infection. It will be important for you to keep your arms and hands down at your sides during the procedure.
You will be given medications to help you relax, also known as twilight sedation, but you may be awake during the procedure so we can ask questions and assess your comfort. A local anesthetic will be given by the physician to numb the procedural site and aid in your comfort. The average device implant procedure may take 2 to 3 hours.
After the procedure:
You will have an incision site covered by a dressing on your chest. You will be observed for signs of bleeding and/or complications frequently by your nurse. You will usually spend a night in the hospital after you get your device placed.
Depending on doctor preference, your arm may be immobilized in a sling to protect the newly implanted lead from moving inside your heart. Before you are discharged from the hospital, your device will be programmed by a pacemaker/defibrillator representative. You will be given instructions on how to care for your incision before you go home.
- Allergic reactions to the contrast or medication
- Abnormal Heart Rhythm
- Puncture of the heart which can lead to bleeding around the heart
- Punctured lung
- Blood clots
- Breathing problems
- Heart attack or stroke
Contact your doctor if:
- Fever greater than 101 and/or chills.
- Redness, swelling, tenderness, and pus-like drainage from the puncture site.
- You have problems taking or obtaining any of your heart medications.
Seek care immediately/dial 911 if:
- Chest pain and shortness of breath.
- Bleeding or swelling from your incision site.
- Coughing up blood.
- You have feelings of dizziness, extreme fatigue, or fainting spells.
Follow up and discharge instructions:
- Keep your dressing clean and dry for 24 hours after the procedure, and then you may remove the outer white dressing leaving the steri-strips in place. Keep your incision clean and dry for 7 days after the procedure. You will be able to shower with the steristrips in place. Do not try to remove them, as they will fall off on their own. DO NOT submerge your incision in water, i.e. in a hot tub, whirlpool, swimming pool, or bathtub.
- Discuss with your doctor about how much you can use the arm on the side of your body where the device was placed. You may be advised by your doctor to not lift anything heavier than 5-10 pounds with that arm and to avoid pushing, pulling, or twisting your arm for 2-3 weeks. You may be given a sling to wear during this time. You are also advised to not raise your arm above your shoulder for six weeks to allow the healing and formation of scar tissue to help the leads adhere in your heart muscle.
- Refrain from using Band-Aids, powders, lotions or creams on the incision site.
- It is normal to have a small amount of bruising and some tenderness at the incision site
- Wear comfortable and loose-fitting clothes for the first 7 days following the procedure.
- Ask your doctor when it is safe to return to work and drive.
- Ask your doctor when it safe to resume sexual activity.
- No driving for 1 week once device has been implanted
- Cleveland Clinic.(2015). Pacemaker Implant. Retrieved from http://my.clevelandclinic.org/heart/services/ImplantableCardiverter-Defibrillator
- Mayo Clinic. (2015). Pacemaker. Retrieved from http://www.mayoclinic.org/tests-procedures/pacemaker/basics/definition/prc-20014279
- MedlinePlus. (2012). Implantable cardioverter-defibrillator. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/007370.htm
If you have any further questions before your procedure please call the office and speak with your physician.
Thank You For Choosing Rose Medical Center For Your Cardiac Care!