How is pacemaker inserted

Generally, the procedure is performed under local anesthesia. Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information. Your browser is out of date With an updated browser, you will have a better Medtronic website experience.

Toggle navigation Getting a Pacemaker. What is Bradycardia? Getting a Pacemaker For Bradycardia. Heart block. This occurs when the electrical signal is delayed or blocked as it travels through the heart muscle. There are several types of heart blocks. Bleeding that can occur from the heart with blood accumulating in the sac pericardium surrounding the heart pericardial effusion.

Lead displacement. This means the wires of leads of the pacemaker become disconnected or displaced. You may need another procedure to reposition them. For some people, having to lie still on the procedure table for the length of the procedure may cause some discomfort or pain. There may be other risks.

This depends on your specific health condition. Be sure to discuss any concerns with your healthcare provider before the procedure. Your healthcare provider will explain the procedure to you and ask if you have any questions. You will be asked to sign a consent form. This gives your permission to do the procedure. Read the form carefully. Ask questions if anything is not clear. Tell your healthcare provider if you are sensitive to or are allergic to any medicines, iodine, latex, tape, or anesthetic agents local and general.

You will need to fast not eat or drink for a certain period before the procedure. Your healthcare provider will tell you how long to fast, usually overnight or at least 8 hours before the procedure. Tell your healthcare provider if you are pregnant or think you might be, or if you are breastfeeding.

Be sure your healthcare provider knows about all medicines, vitamins, herbs, and supplements that you are taking. This includes both prescription and over-the-counter medicines. Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant blood-thinning medicines. This includes aspirin, or other medicines that affect blood clotting. You may need to stop taking some of these medicines before the procedure.

Tell your healthcare provider if you have heart valve disease. You may need to take antibiotics before the procedure. You may get a sedative before the procedure.

This is to help you relax. If a sedative is used and you go home right afterward, plan to have someone to drive you home. You will likely spend at least 1 night in the hospital after the procedure. This is to watch your heart and make sure the pacemaker is working the way it should.

Based on your health condition, your healthcare provider may request other specific preparation. A pacemaker insertion may be done on an outpatient basis. Or it may be done as part of your hospital stay.

The procedure may vary depending on your health and how your healthcare provider does the procedure. You will be asked to remove your clothing and will be given a medical gown to wear. An IV intravenous line will be started in your hand or arm before the procedure. This is to give you medicine and fluids. You will be connected to an electrocardiogram ECG monitor. This records the electrical activity of your heart. It monitors your heart during the procedure using small, plastic electrodes that stick to your skin.

Your vital signs will also be watched during the procedure. These include your heart rate, blood pressure, breathing rate, and oxygen level. A local anesthetic will be injected into the skin of the chest at the insertion site. Once the area is numb, the healthcare provider will make a small cut incision at the insertion site. A sheath is put into a large blood vessel. The sheath is also called an introducer. It's usually put under the collarbone. The sheath is a small plastic tube. The provider will thread the pacer lead wire or wires through this tube into the blood vessel and advance them into the heart.

It will be very important for you to stay still during the procedure. This is so that the catheter does not move. This helps to prevent damage at the insertion site. The provider will thread the lead wire through the sheath into the blood vessel.

They will advance the lead wire through the blood vessel into the heart. A type of moving X-ray is displayed on a TV screen fluoroscopy may be used to help check the location of the leads. There may be 1, 2, or 3 lead wires inserted. This depends on the type of device your healthcare provider has chosen for your needs.

The lead wire is attached to the pacemaker generator. Then the provider will slip the generator under your skin through the incision just below the collarbone. The generator is often placed on the non-dominant side. This means if you are right-handed, the device will be placed in your upper left chest.

If you are left-handed, the device may be placed in your upper right chest. A pacemaker signals the heart to beat when the heartbeat is too slow or irregular. A pulse generator is a small metal case that contains electronic circuitry with a small computer and a battery that regulate the impulses sent to the heart.

The lead or leads is an insulated wire that is connected to the pulse generator on one end, with the other end placed inside one of the heart's chambers. The lead is almost always placed so that it runs through a large vein in the chest leading directly to the heart. The electrode on the end of a lead touches the heart wall. The lead delivers the electrical impulses to the heart. It also senses the heart's electrical activity and relays this information back to the pulse generator.

Pacemaker leads may be positioned in the atrium upper chamber or ventricle lower chamber or both, depending on the medical condition. If the heart's rate is slower than the programmed limit, an electrical impulse is sent through the lead to the electrode and causes the heart to beat at a faster rate. When the heart beats at a rate faster than the programmed limit, the pacemaker generally monitors the heart rate and will not pace. Modern pacemakers are programmed to work on demand only, so they do not compete with natural heartbeats.

Generally, no electrical impulses will be sent to the heart unless the heart's natural rate falls below the pacemaker's lower limit. A newer type of pacemaker, called a biventricular pacemaker, is currently used in the treatment of specific types of heart failure. Sometimes in heart failure, the two ventricles do not pump in a normal manner.

Ventricular dyssynchrony is a common term used to describe this abnormal pumping pattern. When this happens, less blood is pumped by the heart. A biventricular pacemaker paces both ventricles at the same time, increasing the amount of blood pumped by the heart. This type of treatment is called cardiac resynchronization therapy or CRT.

After a pacemaker insertion, regularly scheduled appointments will be made to ensure the pacemaker is functioning properly. The doctor uses a special computer, called a programmer, to review the pacemaker's activity and adjust the settings when needed.

Other related procedures that may be used to assess the heart include resting and exercise electrocardiogram ECG , Holter monitor, signal-averaged ECG, cardiac catheterization , chest X-ray , computed tomography CT scan of the chest , echocardiography , electrophysiology studies , magnetic resonance imaging MRI of the heart , myocardial perfusion scan stress , myocardial perfusion scan resting , radionuclide angiography , and cardiac CT scan.

Please see these procedures for additional information. Note that although an MRI is a very safe procedure, the magnetic fields used by the MRI scanner may interfere with the pacemaker's function. Any patient with a pacemaker should always speak with his or her cardiologist before undergoing an MRI. A pacemaker may be inserted in order to stimulate a faster heart rate when the heart is beating too slowly, and causing problems that cannot otherwise be corrected.

Problems with the heart rhythm may cause difficulties because the heart is unable to pump an adequate amount of blood to the body.

If the heart rate is too slow, the blood is pumped too slowly. If the heart rate is too fast or too irregular, the heart chambers are unable to fill up with enough blood to pump out with each beat. Some examples of heart rate and rhythm problems for which a pacemaker might be inserted include:. Heart block. This occurs when the electrical signal is delayed or blocked after leaving the SA node; there are several types of heart blocks.

If the nearby lung is inadvertently punctured during the procedure, leaking air becomes trapped in the pleural space outside the lung but within the chest wall ; this can cause breathing difficulties and in extreme cases may cause the lung to collapse.

If you are pregnant or suspect that you may be pregnant, you should notify your health care provider. If you are breastfeeding, you should notify your health care provider. For some patients, having to lie still on the procedure table for the length of the procedure may cause some discomfort or pain. There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure:. You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear. Notify your doctor if you are sensitive to or are allergic to any medications, iodine, latex, tape, or anesthetic agents local and general.

You will need to fast for a certain period of time prior to the procedure. Your doctor will notify you how long to fast, usually overnight. Notify your doctor of all medications prescription and over-the-counter and herbal or other supplements that you are taking.

Notify your doctor if you have heart valve disease, as you may need to receive an antibiotic prior to the procedure. Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant blood-thinning medications, aspirin, or other medications that affect blood clotting.

It may be necessary for you to stop some of these medications prior to the procedure. Your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot. Other blood tests may be done as well. You may receive a sedative prior to the procedure to help you relax. If a sedative is given and there is a possibility that you may be discharged, you will need someone to drive you home.

You will likely spend at least one night in the hospital after the procedure for observation and to ensure the pacemaker functions properly. A pacemaker may be performed on an outpatient basis or as part of your stay in a hospital.

Procedures may vary depending on your condition and your doctor's practices. You will be asked to remove any jewelry or other objects that may interfere with the procedure.