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A pacemaker is an implanted device which paces the heart at a programmed rate. It is useful in the management of heart rhythm disorders typically when the pulse is too slow. Bradycardia, or a slow heart rate, may be intermittent or constant and can result in symptoms such as fatigue, shortness of breath, dizziness, lightheadedness or even loss of consciousness.
The implantation of a permanent pacemaker is a relatively minor surgical procedure done with a local anesthetic and usually light sedation. An incision is made below the collarbone and a pocket formed under the skin. The pacemaker leads are passed to the heart through a large vein under the collarbone. The other end is connected to the pacemaker pulse generator which is placed in the pocket. The entire procedure usually takes less than an hour. The risk is low, but possible complications include bleeding, infection or collapse of the lung. The pacemaker will be programmed appropriately prior to discharge from the hospital.
Most routine daily activities can be resumed in several days, but heavy lifting, running, or contact sports should be avoided. An office visit will be scheduled in approximately two weeks following the procedure at which time the wound will be inspected and the pacemaker fully evaluated. Arrangements will also be made for transtelephonic surveillance. The patient is given a transmitter which allows the pacemaker to be checked over the telephone. This is done every other month for the first four to five years and then monthly thereafter. A more complete evaluation is done in the office once or twice a year.
Overall, implantation of a pacemaker is a safe procedure which allows a relatively normal lifestyle to be resumed.