Cardiac Resynchronization Therapy (CRT)

Pacemaker Implantation

A pacemaker is a small, electronic device that is implanted in the chest to regulate heart rhythm. The pacemaker generator is generally implanted under the collarbone. Electrical wire leads are then threaded through the veins in the chest to the heart.

Patient Preparations for a Pacemaker Implantation

Fasting Requirements:

Patients are instructed not to eat or drink anything after midnight prior to a pacemaker-implantation procedure.

Medication Considerations:

Patients taking prescription medication should discuss with ask a physician whether or not these medications should be taken on the day of the procedure. Patients who take blood thinners, such as Coumadin^®, will be advised by their physicians to stop taking this medication for a period of time prior to their pacemaker implantation. Patients with diabetes who are preparing for pacemaker implantation are advised to plan ahead with a physician on how to adjust food and insulin intake before the procedure.

Overnight Arrangements:

Patients should pack a small bag of essentials to prepare for the overnight stay.

What to Expect During a Pacemaker Insertion

• An intravenous (IV) tube will be placed into a vein in the arm. The patient will be given a sedative through the IV.
• Heart rate, rhythm, and blood pressure will be continuously monitored.
• The implantation site will be numbed with a local anesthetic medication.
• An incision is made to create a pocket just below the skin.
• The lead for the pacemaker is inserted into a vein through the chest incision, then it is threaded to and positioned inside the heart. The electrophysiology lab is equipped with special imaging equipment that allows the physician to view the lead as it is threaded towards the heart.
• Once the lead is tested, it is then connected to the pacemaker, which is then programmed to treat your specific type of arrhythmia.
• The incision is closed and covered with bandages.
• The estimated time that it takes for a pacemaker implantation is one to two hours.

What to Expect During Recovery from a Pacemaker Implantation

• A nurse will continue to monitor heart rate, blood pressure, pulses, and insertion site.
• Upon discharge, the patient will be instructed to limit arm movement for three weeks on whichever side that you had the pacemaker implanted.
• It is essential that patients continue to see their physicians regularly for follow-up care.