Pacemaker Implantation

What is a Pacemaker?

A pacemaker is a small, battery-powered device that is implanted just under the skin of the upper chest to control your heartbeat. Most devices have wires, called leads, which are placed inside the heart. The leads monitor your heart rhythm and deliver electrical pulses as needed to keep the heart beating normally.

Hackensack Meridian Health offers a variety of pacemakers, including advanced leadless devices, designed to fit a patient’s specific needs. Types of pacemakers include:

• Traditional pacemakers - Speed up a heart rate that’s too slow by controlling the timing of heart contractions
• Biventricular pacemakers or cardiac resynchronization therapy (CRT) devices - Regulate the heart’s pumping action when the heart is too weak to function properly, as with congestive heart failure
• Implantable cardiac defibrillators (ICDs) - Detect and correct a dangerously fast heartbeat
• Transcatheter Pacing System (TPS) - Tiny, leadless pacemaker that can be implanted using minimally invasive surgery in less than an hour

Some pacemakers have both CRT and ICD device capabilities to regulate pumping action and detect and correct fast heartbeats. Your doctor determines the type of pacemaker based on the type of arrhythmia you have and the overall condition of your heart.

What to Expect

Pacemaker implantation requires minor surgery. Patients are awake during the procedure and receive medicine to control pain.

Using X-ray-guided technology, the electrophysiologist inserts the leads into a vein in the chest, placing one end of the lead in the heart. The leads are tested to make sure they are in the correct position before connection to the device, which is placed just under the skin below the collarbone.

Patients usually stay in the hospital a day after the surgery and will need to limit some activities for a few weeks after the surgery, such as lifting heavy objects or vigorous physical exercise.

Having a pacemaker requires lifelong care and maintenance. The care team will provide specific guidelines for activities and safety precautions — including carrying a pacemaker identification card.

Follow-Up Care

Follow-up care is necessary to ensure that all of the components and programming are functioning optimally for your heart. Checking the battery as the device gets older is especially important.

Routine pacemaker follow up care consists of in-person evaluations with a Registered Nurse once or twice a year – at which time we download information, perform technical testing and reprogram if necessary. Telephone testing is performed by a Technician in-between office visits.