Fitting A Pacemaker
A pacemaker is a battery operated electrical device that is used to correct and regulate an abnormal heart rhythm. It is often fitted under local anaesthetic but sometimes it may be necessary to fit a pacemaker during other forms of heart surgery.
The most common way of fitting a pacemaker is through a vein. This is called the transvenous route. The procedure takes about one hour and is performed under local anaesthetic. It usually involves an overnight stay in hospital (though it can be done as a day case).
After a local anaesthetic is given, a small cut is made on the upper chest region below the collarbone. The wires enter the heart by following the path of a vein under the collarbone (subclavian vein) or the one running along the inside of your shoulder (cephalic vein).
The electrode at the tip of the wire is positioned, with the help of x–rays, to the inner heart wall in the correct chamber. The wires are held in place by specially designed prongs that allow the wire to settle into the tissue and become lodged there in time.
The pacemaker box is attached to the other end of the wires and placed under the skin. Stitches are then used to close the wound.
A chest x–ray will be taken before discharge home from hospital. This is to check the final position of the pacemaker and to ensure your lungs have not been damaged in any way.
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Immediately following surgery the connection is quite vulnerable so it is important that you take a bit of care by avoiding extreme movement of the arm on the affected side or by using it too much. Also avoid any sport or activity where you could get hit or kicked on the area where the pacemaker has been fitted.
It is also important to keep an eye on the wound for about 10 days. If there are any signs of infection such as redness, tenderness, soreness or swelling you should notify your GP immediately, so that antibiotics can be started straight away.
Most stitches will dissolve on their own. If not they will be will be removed 7 to 10 days later, usually by the nurse at your local GP surgery.
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