What is Involved in Pacemaker Surgery?

A pacemaker is an artificial electronic device that may need to be surgically implanted if the electrical signals in the heart are not functioning properly. Symptoms suggesting that there may be problems with the electrical signals in the heart include a low pulse rate, dizziness, and shortness of breath. Pacemaker surgery generally takes an hour or less and is typically done as either an outpatient procedure or only requiring one night in the hospital. This type of surgery is considered minor, and recovery time is minimal in most cases.

The human heart contains a natural electrical system responsible for regulating the rate at which the heart beats. If this system becomes faulty, the heart rate slows and the patient experiences dizziness as well as other uncomfortable symptoms. An electronic pacemaker consists of two primary parts, the pulse generator and leads. The pulse generator creates the electrical signals, and the leads are the wires that carry that signal to the heart.

Before pacemaker surgery, the doctor will explain the procedure and answer any questions. The patient will then sign all of the necessary paperwork granting permission for the surgery. Next, the patient may be hooked up to heart monitors and speak with the anesthesiologist, who will deliver all necessary medications before and during the operation.

The patient is usually awake during pacemaker surgery, so a local anesthetic is given to numb the area where the surgery will take place. An IV is placed in the arm so that the anesthesiologist can quickly and safely deliver any needed medications, including relaxation medications and antibiotics. The patient's heart rate and blood pressure will be monitored during the course of the procedure.

The incision used during pacemaker surgery is generally between 3 and 4 inches (7.6 and 10 mm) long and placed just under the collar bone on the left side of the chest. However, if the patient is left-handed, the pacemaker can be placed on the right side of the chest. The stitches used during pacemaker surgery will dissolve on their own, so there is no need to have them removed later.

Once the pacemaker surgery has been completed, pacemaker function will be tested before the patient is able to leave the hospital. This function will generally be tested once or twice a year following placement. The patient should discuss with the doctor any questions or concerns involving activity restrictions and follow-up care after undergoing pacemaker surgery.