Discharge Instructions for Pacemaker Implantation
You have had a procedure to insert a pacemaker. Once inside your body, this small electronic device helps keep your heart from beating too slowly. A pacemaker can't fix existing heart problems. But it can help you feel better and have more energy. As you recover, follow all of the instructions you are given, including those below.
Don't drive until your doctor says it's OK. Plan to have someone drive you home after the procedure.
Follow the instructions you are given about limiting your activity.
If you are fitted with an arm sling, keep your arm in the sling for as long as your doctor tells you to. Most often, the sling will be removed the following day though you may be instructed to sleep with it on for a period to prevent damage to the pacemaker while it's healing.
Don't raise your arm on the incision side above shoulder level or stretch your arm behind your back for as long as directed by your doctor. This gives the leads a chance to secure themselves inside your heart.
Ask your doctor when you can expect to return to work. Depending on the type of work you do, you may have restrictions until your cardiologist clears you for unrestricted activity.
You can still exercise. It's good for your body and your heart. Talk with your doctor about an exercise plan and the types of exercise to minimize the risk of damaging your pacemaker.
Follow your doctor's directions carefully for wound care. If there is a dressing, ask whether you should remove it or keep it on until your next visit. Never put any creams, lotions, or products like peroxide on an incision unless your doctor tells you to. Do not get the incision wet until your doctor says it's OK.
Every day, take your temperature and check your incision for signs of infection (redness, swelling, drainage, or warmth). Do this for 7 days or as advised by your doctor.
Learn to take your own pulse. Keep a record of your results. Ask your doctor what pulse rate means you should call for medical attention.
Before you receive any treatment, tell all healthcare providers (including your dentist) that you have a pacemaker.
You will be given an ID card that contains information about your pacemaker. Always carry this card with you. You can show this card if your pacemaker sets off a metal detector. You should also show it to avoid screening with a hand-held security wand.
Keep your cell phone away from your pacemaker. Don't carry the phone in your shirt pocket overlying the pacemaker, even when it's turned off.
Stay away from strong magnets. Examples are those used in MRIs or in hand-held security wands. Some pacemakers are now safe to use with MRI scanners. Ask your doctor if you have such a pacemaker.
Stay way from strong electrical fields. Examples are those made by radio transmitting towers, "ham" radios, and heavy-duty electrical equipment.
Don't lean over the open hood of a running car. A running engine creates an electrical field. Most household and yard appliances will not cause any problems. If you use any large power tools, such as an industrial arc welder, talk with your doctor.
See your cardiologist in the next 7 to 10 days. Call and make an appointment as soon as you get home.
Make regular follow-up appointments with your doctor. He or she will check the pacemaker to make sure it's working properly.
Plan on having periodic checkups with your healthcare provider to evaluate the battery life of your pacemaker. Depending on your device and how much your body uses the pacing functions of the pacemaker, you will need a new device generator implanted at some point, generally about every 5 to 7 years.
Some pacemakers have a built-in antenna that can transmit information such as trouble alerts over the internet to your doctor. Ask your doctor if your pacemaker is capable of remote monitoring.
Call 911 if you have:
Severe trouble breathing
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Lack of energy
Twitching chest muscles
Rapid pulse or pounding heartbeat
Shortness of breath
Pain around your pacemaker
Fever above 100.4° F (38° C) or higher, or as directed by your healthcare provider
Other signs of infection such as redness, swelling, drainage, or warmth at the incision site
Your incision is not healing or your incision separates or opens
Hiccups that won't stop
Redness, severe swelling, drainage, worsening pain, bleeding, or warmth at the incision site
If your pacemaker generator feels loose or like it is wiggling in the pocket under the skin
September 04, 2017
Kang, Steven, MD,Snyder, Mandy, APRN