How will I be monitored?
You will be attached to a special monitor so the medical team can keep an eye on your heart rhythm. The monitor consists of a small box connected by wires to your chest with sticky electrode patches. The box displays your heart rhythm on several monitors in the nursing unit. The nurses will be able to observe your heart rate and rhythm.
A chest X-ray will be done to check your lungs, as well as the position of the pacemaker and leads.
Will I be in pain after the procedure?
You may feel some pain or discomfort during the first 48 hours and will be given pain-relieving medication. There may also be some bruising where the pacemaker was inserted. This usually passes within a few days. Tell the staff if your symptoms are persistent or severe.
Getting home from hospital?
Most pacemaker and ICD procedures are done as day cases, so you will get home the same day unless you have complications.
Before you go home, you will be given a pacemaker registration card, which contains details of the make and model of your pacemaker. Always carry this with you in case of an emergency.
You may also wish to wear a MedicAlert bracelet or necklace engraved with important information (such as the type of pacemaker you have, a personal identity number and a 24-hour emergency phone number).
How soon can I drive?
If you have an ordinary driving licence and have had a pacemaker fitted, you can start driving again after one week, as long as:
- you do not have any symptoms, such as dizziness or fainting, that would affect your driving
- you have regular check-ups in the pacemaker clinic
- you have not recently had a heart attack or heart surgery
Inform the Driver and Vehicle Licensing Agency (DVLA) and your insurance company that you have a pacemaker.
If you drive a large or passenger-carrying vehicle, you will have to wait 6 weeks after your pacemaker is fitted before driving again. However, if you have had an ICD fitted you must be shock free for 6 months.
Will I be able to feel the pacemaker?
You will be able to feel it, but you will soon get used to it. At first, it may seem a bit heavy and may feel uncomfortable when you lie in certain positions.
How soon will I be back to normal?
You should feel back to your usual self, or even better than that, very quickly. It is best to avoid reaching up on the side of your operation for four weeks. That means not hanging out washing or lifting anything from a high shelf, for example. However, it is important to keep your arm mobile by gently moving it to avoid getting a frozen shoulder. The physiotherapist can show you how to do this. You will usually be able to do all the things you want to do after around four weeks.
When can I exercise or play sports again?
Avoid strenuous activities for around three or four weeks after having your pacemaker fitted. After this, you should be able to do most activities and sports. However, if you play contact sports, such as football or rugby, it is important to avoid collisions. You may want to wear a protective pad. Avoid extremely energetic activities, such as squash, although skiing should be fine.
How can I care for my wound?
Do not get your wound wet until your stitches have been taken out. After that, avoid wearing anything that rubs that area, such as braces. Women may need a new bra with wider straps. Avoid exposing your wound to sunlight in the first year, as this can cause a darker scar.
Will I have to have my stitches removed?
It depends on the kind of stitches used. Many doctors use soluble stitches that dissolve on their own. Before you go home, you will be told what type of stitches you have. If you need to have stitches removed, this will usually be after 10 days.
What check-ups will I need?
You will usually have your pacemaker checked after 4 weeks at the hospital where it was implanted. Provided this check is satisfactory, you will have your pacemaker checked every 3 to 12 months.
If after having the pacemaker fitted and leaving hospital you feel you're not getting as much benefit as you imagined, your pacemaker may need some small adjustments. The cardiologist or cardiac technician can do this.
Will my pacemaker be affected by electrical equipment?
Most ordinary household electrical equipment is safe to use and will not interfere with your pacemaker. This includes microwaves, as long as they are in good working order.
Specific advice is as follows:
- Mobile phones – it is safe to use a mobile phone, but keep it away from your pacemaker. Use the ear on the opposite side or a headset
- Electronic surveillance – security at airports or anti-theft devices in shops can interfere with your pacemaker. They are safe, as long as you go through quickly and do not linger. Inform security staff that you have a pacemaker as it can set off the alarm
- MRI scan – you must not have an MRI scan (body imaging scan) as it uses strong magnets. Other scans are safe. However, MRI-safe pacemakers are becoming more common now so check which one you have with your pacemaker clinic or doctor if this situation arises
- Lithotripsy – this treatment for kidney stones must be avoided if you have a pacemaker
If your job brings you into contact with strong electrical fields, such as arc welding, diathermy or working with high power radio or TV transmitters, or you have direct contact with car ignition systems, check with your cardiologist or pacemaker technician before returning to work.
Will I need to have another pacemaker?
Most pacemaker batteries last for 8 to 10 years. After this, you will need to have the batteries changed. This involves replacing the pacemaker box with a new unit. This is a simple procedure that may or may not require an overnight stay in hospital. The original lead or leads can usually be left in place, although occasionally they will need to be replaced too.
How often will I need follow-up appointments?
You will need follow-up appointments for the rest of your life. These may be every 3 to 12 months, depending on the type of pacemaker you have and how well it works.
At the follow-up appointment, the technician or doctor will analyse the discharge rate of your pacemaker, measure the strength of the electrical impulse and record the effects of the impulse on your heart. Most modern pacemakers can store information about the state of the battery and the performance of the impulse generator. Your pacemaker can then be reprogrammed to the best settings for you, if necessary.
Will my sex life be affected?
Some heart medications can affect a man's ability to get an erection. Try to relax and not anticipate problems - anxiety about performance may be the cause rather than your medication. If you suspect that a drug you're taking is causing erection problems, talk to your GP.
There is no reason you cannot continue to have a good sex life after your pacemaker is implanted. Talk to your partner about any worries you may have, such as the fear of opening up your scar, and work out ways to get around them. If you do not feel like having full penetrative sex straightaway, there are many other ways to express your intimacy, so use your imagination.
The risk of sex triggering a heart attack is low - around 1 in 1 million.