American Medical Association Family Medical Guide - American Medical Association [342]
After the Procedure
You will leave the hospital the day of the procedure or the following day. You will be asked to keep the incision dry for about a week. For at least 8 weeks after the procedure, you will need to limit your movement, particularly on the side where the pacemaker is implanted, to prevent the wires from disconnecting. Your doctor will ask you to avoid making sudden, jerking arm movements or raising your arms above your head. You will also need to avoid all strenuous activities that involve the use of your arms, such as tennis, swimming, sweeping, raking, scrubbing, or lifting and carrying heavy or bulky objects. After 8 weeks, when the wires will be set in place, you can resume your usual activities.
The pacemaker’s power source operates like a tiny computer. By placing an external control device on your chest over the pacemaker, your doctor can examine the pacemaker and reprogram it if necessary. Some pacemakers provide information about how the heart is functioning. A person can also transmit information from his or her pacemaker over the telephone to the doctor’s office. Your doctor will examine your pacemaker about 2 weeks after surgery and again about 3 and 6 months after surgery. After that, he or she will continue to examine your pacemaker at regular intervals, at least once a year, to help ensure that it is functioning properly.
A pacemaker is powered by a tiny battery that is designed to last 8 to 10 years. When the battery begins to run low, it gives off a warning signal that can be detected by an external control device or over the telephone many months before it actually fails. Your doctor can replace the battery quickly and easily in a minor surgical procedure.
Most household appliances do not affect newer pacemakers, but cellular phones, MRI (magnetic resonance imaging) scanners, and diathermy (a form of physical therapy that uses heat) machines can interfere with a pacemaker and may cause it to stop functioning. Ask your doctor what devices and situations you need to avoid to protect your pacemaker.
Implantable Defibrillators
Implantable defibrillators are used to treat ventricular fibrillation (see Cardiac Arrest; page 581). Surgery to implant a defibrillator is similar to the implantation of a permanent pacemaker.
Your doctor will monitor the defibrillator at regular intervals to ensure that it is working properly and to check the battery. When the battery signals that it is running low, the doctor removes the old defibrillator and implants a new one.
The same precautions and restrictions that apply to pacemakers apply to implantable defibrillators. However, if you have an implanted defibrillator, you should not drive a car or operate heavy machinery because of the risk that you could briefly lose consciousness when the defibrillator sends an electrical impulse to your heart.
Living With a Pacemaker or Implantable Defibrillator
Once you have recovered from the implantation surgery, you can return to your usual daily routine. Most people do not have any problems as long as they follow all their doctor’s instructions, which usually include eating a prescribed diet, taking medication, and keeping all follow-up appointments.
Your doctor will give you a card that indicates that you have a pacemaker or implantable defibrillator. Always carry this card with you so that emergency medical personnel will know what treatment to provide in case of an emergency. Most people who have a pacemaker or implantable defibrillator become very aware of their heart and how it is supposed to function.