What does having a pacemaker fitted involve?
A pacemaker is an implantable electrical device that helps regulate your heart rhythm. It usually sits under the skin just below your left collarbone (although in certain circumstances it may be placed on the right).
Pacemakers are most commonly fitted in people with underlying arrhythmias — particularly an abnormally slow heart rate. This can sometimes be linked to previous heart attacks, heart failure, or cardiomyopathies.
How long does pacemaker surgery take?
On average, pacemaker surgery takes around one hour. Because it’s a small implant, your consultant cardiologist can place it under the skin and have it wired up and working relatively quickly.
With it being a short operation, will I be awake?
This depends on your individual circumstances, but in the majority of cases, pacemakers are fitted under local anaesthetic — meaning you’ll be awake, but the area will be numbed so you shouldn’t feel pain.
During the procedure, your cardiologist will:
- Give you a local anaesthetic to numb the area
- Make a small cut just underneath your collarbone
- Pass the wire (or wires) for the pacemaker through a vein and into your heart
- Make a pocket under your skin
- Insert the pacemaker into the pocket
- Run tests on the pacemaker to make sure it’s working properly (sometimes referred to as “pacing”)
- Close the cut with dissolvable or non-dissolvable stitches
After the procedure, you’ll recover in our post-procedure pods before going home.
What does a pacemaker do?
A pacemaker works by monitoring your heart rhythm and stepping in if your heart rate drops below a certain level. It can override your heart’s intrinsic rhythm when needed.
In some cases, pacemakers can also have a dual function and act as a defibrillator, delivering a shock if a rhythm becomes life-threatening.
Is pacemaker surgery dangerous?
Pacemaker surgery carries some risk, as with any procedure, but it is generally considered very safe and far less dangerous than more intensive heart surgery.
Most people make a good recovery after having a pacemaker fitted, and complications are uncommon.
What are the risks of having a pacemaker?
As with all surgical procedures, there are some potential side effects and complications. These can include:
- infection at the pacemaker box or on the wire
- lead displacement (where the lead moves from where it was originally positioned)
- bruising where the pacemaker was inserted
- blood clots
- pneumothorax (collapsed lung)
- pacemaker syndrome (your own heartbeat and the pacemaker interfere with each other)
- pacemaker malfunction (the device stops working properly or fails)
Will I experience pain afterwards?
Some discomfort and bruising are common, especially around the incision site and collarbone area. This usually settles after a few days.
How to prepare for having a pacemaker
Your consultant will let you know if you need to stop taking any medications before your procedure. They’ll also tell you if and when you need to fast (stop eating and drinking).
You should also arrange for someone to pick you up after the procedure, as you won’t be able to drive immediately afterwards.
Recovery and aftercare
Although pacemaker surgery takes place in an important area, it’s not as invasive as many people expect — and most patients feel well again quite quickly.
After your procedure:
You’ll need to keep the area around your cut dry for a period of time (your consultant will advise how long)
Your stitches may dissolve on their own, or may need removing depending on the type used
You’ll be asked to avoid vigorous activity for around 4–6 weeks
This includes lifting, strenuous movement, and cardio exercise
You may be advised to practice gentle arm and shoulder movements to keep the area mobile
Arm movement restrictions
One important thing to remember is that you’ll need to avoid raising the arm on the same side as your pacemaker for at least a month. This means no lifting your arm above shoulder height on that side during early recovery.
Most people recover and resume normal activities within around 6 weeks.
Follow-up appointments
Your consultant will see you for follow-up appointments where they’ll check your pacemaker and how you’re feeling. They may also adjust the pacemaker settings if needed.
Using electrical appliances
Any electrical equipment that produces a strong electromagnetic field can interfere with a pacemaker. However, most household appliances — such as microwaves and hair dryers — won’t cause a problem if they’re used at least 15cm away from your pacemaker.
If you ever feel dizzy or notice your heart beating faster while using an electric appliance, move away and allow your heartbeat to return to normal.
Should I expect any lifestyle restrictions long-term?
No — most people feel the benefits within a few weeks, and a pacemaker should not limit your lifestyle once you’ve fully recovered.