Post pacemaker implant
Wound
The wound must be kept clean and dry for at least a week, preferably with the dressing left in situ. Do not soak the wound in the bath until fully healed, a shower avoiding the wound area is fine.
If there are any signs of infection around the wound (hot, redness, discharge) go straight to your GP. Your GP will probably start you on antibiotics. If the skin over the pacemaker is broken, and there are visible pieces of pacemaker or lead, attend hospital (A&E department) immediately as admission is likely for further intervention.
Stiches
Your wound was closed with dissolvable stitches/non dissolvable stitches/glue.
Dissolvable stitches DO NOT need removing, the nurse at your GP surgery can review the wound in 7-10 days. Occasionally the stitches do not fully dissolve, the Physiologist will review the wound at your first pacemaker clinic and advise if there are remaining stiches needing removal.
Non dissolvable stitches need to be removed, please make an appointment with the nurse at your GP surgery to have this performed. Usually this would be 7-10 days post implant.
Glue also acts like a semi waterproof dressing. You should not try to remove any of the glue, it will gradually come off on its own. It can sometimes look like your skin is peeling, visit your GP if you are concerned.
Arm movement
The pacemaker leads use a vein that also travels down your arm. It is imperative that you restrict movement of the arm. This means the elbow MUST be kept below shoulder level for 7-10 days. We encourage you to move the arm a little to prevent the shoulder getting too stiff.
Avoid lifting heavy bags or leaning too much on the arm for a few days. The arm on the opposite side to the pacemaker implant is not restricted in any way. Avoid playing contact sports such as rugby, as these can cause heavy impact onto the pacemaker site.
Driving
The law bans you from driving for one week after pacemaker implant. Before driving again you MUST inform the DVLA and you insurance company that you have a pacemaker. Your insurance company should not increase you premium, we have made you safer!
Electrical appliances
Most household electrical appliances are perfectly safe to use, so long as they are in good electrical working order. Do not stand in front of the microwave for prolonged periods; this also applies to people without pacemakers! We discourage use of arc welding as this produces large electrical fields which can interfere with normal pacemaker function.
The use of a Nintendo Wii system is not recommended due to the signals the wireless systems use. Wireless headphones are fine to use.
Holidays & travelling
The pacemaker does not restrict any travel, but please remember to carry your pacemaker ID card and tell airport security you have an implanted device. We would recommend anyone travelling abroad has appropriate travel insurance.
Telephones
Mobile telephones are safe to use but a recommended distance of 6 inches/15cm should be kept between the phone and your pacemaker. For this reason we recommend that you do not store your phone in a shirt pocket, and that you use the phone on the opposite ear to the pacemaker site. Normal cordless landline phones in the home are not restricted.
Peacemaker follow up clinic
We need to review the device on a regular basis to ensure the leads, battery and programming are optimised and pick up any possible problems early.
4-6 weeks from implant – this is one of the most important checks. At this check we need to check the wound has healed well, and that the leads have settled into good positions. If the leads are good, we can reduce the voltage being used to pace your heart. This can significantly prolong battery life. We also look at the heart rate histograms and may make other programming changes. Please tell us if you are getting any symptoms as we may be able to improve your symptoms by reprogramming.
6-9 monthly – This is a routine follow up, again we test the leads, check the battery and see if we need to reprogram anything to optimise device function or to improve symptoms. Although the battery should last 8-15 years, the device must be checked at least annually. Occasionally we find problems with the device or leads and we will advise you of any action needed, including if an intensified follow up is required.
Please advise us if you need to change your pacemaker follow up appointment, we appreciate that sometimes booking appointments so far in advance may mean we occasionally have to move the appointment by up to a couple of weeks.
Still have any concerns?
Your GP is always your first point of contact. Your GP may then contact us if necessary or refer you to see one of the cardiology doctors or attend a pacemaker clinic.
Please remember to always carry a copy of your pacemaker ID card.