Why Do I Need a Pacemaker?
People have a pacemaker put in place for low heart rate, sometimes complete heart blockage where the upper chambers are no longer able to transmit the impulse to the lower chambers. A patient usually has a problem with the “wire” if you will that transmits the signals.
What Can I Expect When Having A Pacemaker Surgery?
Having a pacemaker put in is usually a minor surgery and usually takes an hour sometimes it’s a lot quicker or slower. If your family members are in the waiting room they may think it takes two hours or longer because there’s a lot of paperwork beforehand and paperwork after. Just like most surgeries you won’t have anything to eat or drink after midnight, we might have you hold off taking certain blood thinner medications. Usually we have people who are on Plavix or aspirin, or other anti-platelet agents to continue those medications.
Before the surgery, the anesthesiologist will make you sleepy, it’s a lighter sleep. It’s called conscience sedation. It will be moderate or deeper than that. If we sense that you are starting to feel pain, the will adjust the sedation. What we do is make an incision to form like a pocket, to place the pacemaker in. It will usually be on the left side of your chest. That is the traditional placement area for your pacemaker. We will connect leads down in to the heart. We put it all under the skin. You will be given some numbing medicine around the incision so you won’t feel any pain. For a new device, you can almost always expect to spend the night in the hospital. Nobody generally goes home the same day. It is most likely that you will go home the next day unless we see an issue. You will get pain medicine overnight and antibiotics before and after the surgery. The device will be checked the next day to make sure the leads are in place and that the heart has not rejected any of leads. There is a follow up visit to check the surgical wound and for optimizing the device for your particular needs.
What Are The Risk of Pacemaker Placement Surgery?
We generally tell people with any surgery or procedure that there is a risk of stroke, heart attack, and death. Just like any surgery, if you had you gall bladder out, your appendix out, or even a colonoscopy, there is always that risk of things happening. The main risk with this type of surgery is a collapsed lung. We work with needles around the lungs so there’s a one percent chance of a perforation of the lung and that’s treated with a chest tube. The other typical risk is perforation of heart. Again these are generally a one percent less risk of that happening. When we put leads in to the heart there is a small chance that one may perforate through. If that happens it’s generally treated with a chest tube, a tube that goes in under the breast bone to drain the blood away from the heart. It can require open heart surgery to fix the hole in the heart, depending on the situation. There is a risk of infection. That is about one percent maybe higher that the device will come infected. If that happens it must be taken out and replaced when the infection is over. You can even have that type of infection much later in life. This would be a server infection that involves the bloodstream. It would be one of those once in a lifetime type infections. Again, an infection can seed that device just like an artificial hip or artificial heart valve and the device has been taken out, we must clear the infection, and replace the device once the infection is over.
Risk of lead dislodgement. There is about a one percent chance of that happening. If it happens to you, we have to go back in and fix the lead back into the heart. There’s some restrictions on lifting your arm. Usually we ask you not to lift your arm between 4 and 6 weeks after your surgery. You should not lift your arm more than 90 degrees. If you lift your arm higher than that you’re going to pull leads out of the heart and you’ll have to go back in with repeat surgery.
Do you have more questions about having a pacemaker? Why not speak to one of our caring cardiologist about pacemaker surgery. Start by calling 702-475-5115 or using our online form here.