Patient education: Pacemaker insertion – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is pacemaker insertion? — This is surgery to put a pacemaker in the body.

A pacemaker is a device that sits under the skin near the heart (figure 1). It can treat an abnormal heart rate. "Heart rate" means how fast the heart is beating.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Take all of your medicines as instructed.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision.

•Keep your incision dry and covered with a bandage (unless it is closed with surgical glue). Your doctor or nurse will tell you exactly how long to keep your incision covered.

•Your doctor will tell how long to keep your incision dry. In general, people with surgical glue can shower the next day. Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

•Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Avoid lifting more than 10 pounds (4.5 kg) and activities such as golfing, tennis, swimming, bowling, and yard work for about 6 weeks. Your doctor or nurse will tell you exactly how long to avoid these and other activities and when you can go back to work.

•Avoid raising your arm high on the side where the pacemaker was inserted for about 6 weeks. Ask your doctor and nurse how long to avoid raising your arm.

●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.

●Take a stool softener to help with constipation, if needed. Opioid pain medicines can cause constipation.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

You will have regular visits with your doctor after getting a pacemaker. During these visits, they will check that the pacemaker is working properly and check the battery life. In many cases, your doctor might be able to check on your pacemaker remotely. Most pacemaker batteries last 6 to 15 years.

What else should I know? — There are things you will need to do as you get used to living with a pacemaker:

●You will be given an information or ID card about your specific pacemaker. This includes the device maker, serial number, and date that the pacemaker was put in. Keep this card in a safe place, and carry the card (or the information on it) at all times.

●It's a good idea to wear or carry a medical alert ID to let others know you have a pacemaker. These can include bracelets, necklaces, shoe tags, or cards that you carry in your wallet. This can help if you ever need emergency medical care.

●Avoid certain electric or magnetic sources or equipment. Your doctor will tell you what you can be near, and what you should avoid. For example, people with a pacemaker can be near TVs, radios, and microwaves.

●Tell airport security that you have a pacemaker when you travel. The metal parts of a pacemaker could set off a metal detector alarm. For this reason, airport security might use a different type of screening. A metal detector or X-ray machine will not harm the pacemaker.

●In some cases, the strong magnet in a cell phone can affect your pacemaker. If you are not sure if your device could affect your pacemaker, check with the company that made it, or ask your doctor. To be safe, carry your cell phone in a pocket or bag below your waist so it is not right next to your pacemaker.

●Tell other doctors or nurses that you have a pacemaker, especially before having any imaging tests or procedures, such as an MRI.

●Learn how your pacemaker works, and understand the heart rate settings. This information is helpful in case of a medical emergency.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel faint or like you might pass out.

●You are dizzy or short of breath.

●You have chest pain.

Call for advice if you have:

●A fever of 100.4°F (38°C) or higher, or chills

●Redness or swelling around the cuts from your surgery

●Nausea or vomiting for more than 2 days after going home

●The same heart symptoms you had before your pacemaker was put in

●Hiccups that do not go away

More on this topic

Patient education: Pacemaker insertion (The Basics)
Patient education: Pacemakers (The Basics)
Patient education: Implantable cardioverter-defibrillators (The Basics)
Patient education: Atrial flutter (The Basics)
Patient education: Sinus node dysfunction (The Basics)
Patient education: Syncope (fainting) (The Basics)
Patient education: Cardiac resynchronization therapy (The Basics)
Patient education: Bradycardia (The Basics)

Patient education: Pacemakers (Beyond the Basics)
Patient education: Implantable cardioverter-defibrillators (Beyond the Basics)
Patient education: Atrial fibrillation (Beyond the Basics)
Patient education: Syncope (fainting) (Beyond the Basics)