Step-by-Step Guide to Getting a Pacemaker

Did you know that the average heart beats about 100,000 times per day, which calculates to about 35 million times per year? If your heart rate is falling short of these numbers, dangerously so, a pacemaker is an excellent solution.

There are about 3 million Americans who are living with pacemakers, and if you’re about to join these ranks and want to learn about the implantation procedure, you’ve come to the right place.

The team here at Advanced Cardiovascular Specialists has a great deal of experience installing pacemakers to improve cardiac function in our patients. 

In the following, we provide brief, step-by-step looks at what we do during different kinds of pacemaker implantations.

The type of pacemaker

The reason why we’re covering each pacemaker separately is that implantation can vary greatly depending upon the type of device. We're also describing pacemaker installations here that are pre-planned — it's important to note that pacemakers  are often placed in emergency situations.

Assuming that this is a planned procedure, here are some guidelines for what we do when we place a pacemaker.

Getting you comfortable

When you first arrive, we make you comfortable on the surgical table. Once in position, we administer an IV sedative that will keep you pain-free as we install your pacemaker. We also use a local anesthetic in the areas where we're going to make small incisions.

Getting a wireless pacemaker

If we’re installing a wireless pacemaker, we only make a small incision in your thigh to access your femoral artery. Using live imaging to guide us, we thread a catheter through the blood vessel up to your heart. Using this access point, we deliver and install the leadless pacemaker, which is usually between 1-1.5 inches long, into your heart’s right ventricle.

Once we get your wireless pacemaker into the right position, we attach it to the chamber wall and then remove the catheter from your artery. In total, this implantation procedure usually takes us less than an hour to complete.

Getting a wired transvenous pacemaker

If we’re installing a two-piece unit — the leads and a battery pack — we  typically install the leads and electrodes first through blood vessels in your neck, chest, or thigh. We use live imaging to guide the placement of these electrodes into your heart.

Once the leads are in position, we make a small incision and install the generator just under your skin, usually around your chest or abdomen, connect the leads, and then close the incision.

This pacemaker implantation procedure usually takes us about an hour or two to complete.

Getting an epicardial pacemaker

If you have an issue with your blood vessels or an infection in your heart, we might place an epicardial pacemaker, which means we attach the leads to the outside of your heart. 

For this type of implantation, we place you under general anesthesia and make an incision under your ribs or around your armpit to place the leads and generator.

We hope we’ve painted a clearer picture about your upcoming pacemaker procedure. If you still have questions, please don't hesitate to contact our office in Mountain View, California.

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