Heart pacemaker

A heart pacemaker is a small device implanted under the skin in the chest to restore a normal heart rate. The pacemaker senses if your heart is beating irregularly and sends mild electrical impulses to help your heart keep a normal rhythm. The impulses are painless and undetectable. A pacemaker allows your heart to maintain a satisfactory heart rate, which is needed for healthy blood flow.

Most pacemakers have two parts: a pulse generator and leads. A pulse generator is a small metal box with a battery and electrical parts that control the electrical signals sent to the heart. The leads are flexible wires placed in one or more of the heart’s chambers that send electrical signals to the heart.

There are several types of pacemakers:

• Leadless attaches to the inner wall of the heart. This type of pacemaker doesn’t use wires. 
• Single chamber sends electrical signals to one chamber of the heart. 
• Dual chamber sends electrical signals to two chambers of the heart. 
• Biventricular stimulates both lower heart chambers and makes the heart muscle stronger. It’s typically used for people with heart failure and a slow heartbeat. It’s also called cardiac resynchronization therapy.

Before your pacemaker implantation surgery, your provider will explain how it’s done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery. In general, pacemaker implantation is considered a minor procedure.

Each pacemaker surgery is done differently, but you can expect the following:

• Your surgery will be done at a hospital or surgery center. 
• An IV (intravenous) line will be placed in your vein so anesthesia can be administered. Most patients are awake during the procedure. 
• Your doctor will make a small incision in your collarbone and place the pacemaker. Your Penn Medicine care team will be by your side to make sure you’re comfortable during the procedure. 
• The procedure takes an hour or longer.

Recovery from pacemaker placement surgery typically takes a few weeks. Your arm will be in a sling for a day or two, and upper body motion will be restricted for up to six weeks. It’s important to follow your doctor’s advice, such as avoiding heavy lifting and strenuous physical activity to allow the incision site to heal properly. You’ll have a follow-up visit to check the pacemaker and ensure it’s working properly.

The risks of heart pacemaker surgery are low, but like any medical procedure, there are some potential risks that could include abnormal heart rhythms, bruising or pain after implantation, and device malfunctions.

It’s important that you communicate any concerns or unexpected side effects with your Penn Medicine provider. Your care team is skilled and experienced and will do everything possible to provide the best care during and after your surgery.

Living with a heart pacemaker

Once you have recovered from your surgery, your provider will talk to you about steps you can take to have the best possible outcome when living with a pacemaker.

• Carry an ID card: Print a copy of the American Heart Association Pacemaker Identification (ID) Card and carry it in your wallet in case of an emergency. All medical professionals should be aware that you have a pacemaker before treating you. 
• Attend checkups: Your doctor will monitor your pacemaker regularly and adjust it if needed. In addition, they may want you to send information from your pacemaker between checkups. 
• Share the news: Notify all your healthcare providers about your pacemaker to ensure they don’t recommend tests that could interfere with it. This includes doctors, dentists, physical therapists, and others. 
• Show caution near certain devices: You’ll have to use certain devices with caution, such as electronics with strong magnetic fields and metal detectors. Ask your doctor about devices that you may need to avoid. 
• Take medications as prescribed: Some patients are prescribed heart medicines that must be taken as recommended by their doctor.

Pacemaker implantation with expert cardiovascular care at Penn Medicine

Our doctors remain at the forefront of cardiovascular practices and techniques. Our cardiologists offer expert diagnosis and treatment for a wide range of heart conditions. When you work with our healthcare teams, you can expect:

• Researchers dedicated to scientific discoveries: The Penn Cardiovascular Institute uses heart and vascular research to develop new clinical devices and treatments for heart-related diseases. 
• Care close to home: We meet with patients in satellite locations across the region allowing convenient consultations, second opinions, and pre- and post-operative care right in your community.