Pre-Procedure / Post-Procedure Instructions |
||
|
Pacemaker Implant Before the procedure: Your healthcare provider might ask you to have your blood work (INR) checked about a week or a few days before your procedure so that we can be sure that your blood is not too thin for the procedure. Medication instructions:
Also, you will be asked not to have anything to eat or drink (including water) for 6-8 hours before your procedure. You may be allowed to take your other medications that morning with a small sip of water, but talk to your doctor first. At the time of your procedure, you will be taken into the EP lab (electrophysiology procedure room). This looks like an operating room, and has special X-ray equipment, and monitors around the room which will be used to help the physicians look at your heart. An intravenous line (IV) will be started in your hand or arm. This will be used to give you sedatives, pain medicine, and heart medicines during the procedure. ECG patches and other monitoring equipment will be attached to you so that the staff can monitor your heart rate and blood pressure during the procedure. These areas on the groin, neck, shoulder or arm may be cleansed and shaved to prepare for the placement of the special procedure catheters or the pacemaker. During the procedure: The doctor will make a small incision (about 2-3 inches long) in the skin just beneath the collarbone to make a pocket for the pacemaker. A thin flexible coated wire or “lead” will be passed down through a large vein that leads into the heart until it reaches the chamber of the heart that is to be paced.
Depending on your needs, you may receive one, two or three leads: right atrium (upper chamber), right ventricle (bottom chamber) and sometimes the left ventricle. Next, the leads will be tested to be sure they pace your heart (make it contract or squeeze). Once the leads are connected to the pacemaker, the doctor will slide the pacemaker into the pocket under the skin. The skin incision will heal in a few weeks. After the procedure: Once the procedure is done, the doctor will remove the catheters from the veins. One of the physicians or nurses will hold pressure over the area where the catheter was inserted while the opening forms a clot. This usually takes 10-20 minutes. You will continue to be monitored during this time. Please let the nurse know if you feel uncomfortable. Once you are fully awake, the nurses will take you back to your room. A heart rhythm monitor will be applied there so that we can continue to monitor your heart rhythm overnight. You will need to lay flat in bed for a few hours (the nurse will give you specific instructions) to prevent bleeding or oozing from the catheter insertion sites. You will be told not to raise your arm or move it very much during those first few hours. You will be need to stay in your hospital bed for 12 hours after the pacemaker is implanted to prevent the leads which were implanted in your heart from coming loose (dislodged). You may have an ice bag placed over your shoulder incision to prevent bruising. Specific information related to the pacemaker : Right after the procedure, you may notice bruising around the pacemaker incision or over the chest, side or arm near the incision. This is normal and will fade over the next few weeks. Sometimes, especially if you take blood thinners, you are more prone to bruising. Call your doctor if you notice that the bruise is getting worse, or if there is a bulging area under the incision –like a golf ball—that wasn’t there before. Please know that even though a pacemaker is small, you can usually see it under the skin, but that is different from a bulging bruise. Call your doctor if you are unsure. You will also want to keep the incision dry for 3 days and watch the incision for signs of infection (redness, swelling, drainage). If you notice any signs of infection please call your doctor or the pacemaker nurse. You will be given specific instructions about your pacemaker and how to take care of it and yourself before you leave the hospital. These instructions will include information about returning to normal activity, how to take care of the incision, and what you need to know about living with a pacemaker. Most people are able to return to most of their normal activities by the third or fourth week after the pacemaker implant. You will be given an appointment to follow up with your doctor or the pacemaker clinic. They will evaluate (interrogate) your pacemaker and make programming changes as needed.
|
