Pacemakers

The specialists at UPMC in Central Pa. perform hundreds of pacemaker insertions each year to treat abnormal heart rhythms.

What is a pacemaker?

A pacemaker is a small battery-powered device that is permanently implanted under your skin (most often in the shoulder area just under the collarbone). It sends electrical signals to start or regulate a slow heartbeat.

A pacemaker is made up of a pulse generator that produces electrical signals, wires (known as leads) that conduct electrical signals to the heart from the pulse generator, and electrodes.

Using electrodes attached to the generator and battery, the pacemaker is wired to your heart. Just like a little computer, your pacemaker can "sense" when your heart's natural rate falls below the rate that it has been programmed to maintain. Using this information, the pacemaker figures out what electrical pulses your heart needs and how often they should be given.

Why do I need a pacemaker?

When your heart's natural pacemaker or electrical circuit malfunctions, the electrical signals in your heart often become erratic. Erratic electrical signals, also known as arrhythmias or abnormal heart rhythms, can cause your heart to beat too slow, too fast, or too irregularly. A permanent pacemaker can be used to correct an abnormal heart rhythm if it is too slow or erratic, or if the electrical pathways in your heart are blocked.

How do I prepare for a pacemaker procedure?

Your doctor will explain the pacemaker procedure to you and give you the opportunity to ask questions. To prepare for a pacemaker, you should:

• Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape or anesthetic agents (local and general).
• Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
• Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure.  Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
• Fast for a certain period of time prior to the procedure. Your doctor will tell you how long to fast (usually overnight).
• Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

What happens during a pacemaker procedure?

A pacemaker is inserted by your cardiologist in either the cardiac catheterization or electrophysiology laboratory. You will receive local anesthesia to numb the incision site. Sedation medication can be given to help you relax and many patients sleep during the procedure.

Your doctor will make a small incision just under your collarbone to insert the lead(s) into your heart through a blood vessel. After the lead is in place, it will be tested to make sure it is in the right place and is working properly. The lead is then attached to the generator, which is placed just under your skin through the incision.

What can I expect after a pacemaker procedure?

You may be taken to the recovery room for observation or returned to your hospital room where a nurse will monitor your vital signs. You should immediately inform your nurse if you feel any chest pain, tightness, or any other pain at the insertion site. The insertion site may be sore or painful and pain medication may be administered if needed.

After a period of bed rest, you may get out of bed without assistance. A nurse will assist you the first time you get up and will check your blood pressure while you are lying in bed, sitting and standing. You should move slowly when getting up to avoid any dizziness from the period of bedrest. You will be able to eat and drink after you are completely awake.

After your blood pressure, pulse, and breathing are stable, you will be taken to your hospital room. You will likely be required to spend a night or two in the hospital so your health care team can make sure your pacemaker is working properly. After you are discharged, you should arrange to have someone drive you home from the hospital.

How long does it take to recover after a pacemaker procedure?

After you arrive home, it will be important to keep the insertion site clean and dry. You will be given instructions about bathing and showering.

You should be able to return to your daily routine within a few days. Your doctor will tell you if you need to take more time in returning to your normal activities. In addition, you should avoid lifting or pulling on anything for a few weeks. You may be instructed to limit movement of the arm on the side where your pacemaker was placed depending on your doctor’s preferences.

Based on the nature of your job, your overall health and your progress, your doctor will determine how soon you may return to work. You will not be able to drive until your doctor gives approval. These limitations will be explained to you if they are applicable to your situation.

Notify your doctor to report any of the following:

• Fever and/or chills
• Increased pain, redness, swelling, bleeding or other drainage from the insertion site
• Chest pain or pressure, nausea and/or vomiting, profuse sweating, dizziness and/or fainting
• Palpitation

Your doctor may give you additional or alternate instructions after the procedure, depending on your situation. In most cases, you will be able to lead a normal life that includes daily activities and exercise.

After implantation of a pacemaker, you must be aware of your surroundings and devices that may interfere with its operation. Potentially disruptive devices include those with strong magnetic fields. The manufacturers of pacemakers have different restrictions depending on your device. You should refer to the company’s guidelines for specific instructions regarding your pacemaker.

How long do pacemakers last?

Pacemakers generally last 5-7 years or longer (depending on usage and the type of device). You should have your pacemaker checked regularly to make sure it is working properly.

You will also receive an identification card from the manufacturer that includes information about your specific model of pacemaker and the serial number, as well as how the device works. You should carry this card with you at all times so that the information is available to any health care professional who may have reason to examine and/or treat you.

Need more information?

Cumberland/Dauphin/Franklin/Lebanon/Perry Counties: 717-731-0101
Adams/York Counties: 717-637-1738 or 717-849-5576
Lancaster County: 717-299-5000

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Locations

UPMC Heart and Vascular Institute
Located at UPMC Outpatient Center
1251 East Main Street
Suite 3
Annville, PA 17003
Adult Cardiology: 717-731-0101
Pediatric Cardiology: 717-761-0200

UPMC Heart and Vascular Institute
360 Alexander Spring Road
Carlisle, PA 17013
Adult Cardiology: 717-243-6557
Pediatric Cardiology: 717-761-0200
Fax: 717-243-0102

UPMC Heart and Vascular Institute
2020 Technology Parkway
Mechanicsburg, PA 17050
Adult Cardiology: 717-731-0101
Pediatric Cardiology: 717-761-0200
Fax: 717-731-8359 

UPMC Heart and Vascular Institute
900 Century Drive
Suite 100
Mechanicsburg, PA 17055
Phone: 717-591-3660 or 800-248-0257
Fax: 717-591-3661

UPMC Heart and Vascular Institute
Located at Medical Professional Center of Newport
300 Bretz Court
Newport, PA 17074
Phone: 717-567-7246 or 800-248-0257
Fax: 717-567-2621 

UPMC Heart and Vascular Institute
2808 Old Post Road
Harrisburg, PA 17110
Adult Cardiology: 717-920-4400
Pediatric Cardiology: 717-761-0200
Fax: 717-920-4401

UPMC Heart and Vascular Institute
12 Saint Paul Drive
Suite 205
Chambersburg, PA 17201
Adult Cardiology: 717-217-6881
Pediatric Cardiology: 717-761-0200
Fax: 717-217-6889

UPMC Heart and Vascular Institute
Located at Commerce Park Professional Center
20 Expedition Trail
Suite 203
Gettysburg, PA 17325
Phone: 717-637-1738
Fax: 717-646-7430

UPMC Heart and Vascular Institute
Located at UPMC Outpatient Center
2201 Brunswick Drive
2200
Hanover, PA 17331
Phone: 717-637-1738
Fax: 717-646-7430

UPMC Heart and Vascular Institute
Located at Medical Office Building
310 Stock Street
Suite 3
Hanover, PA 17331
Phone: 717-637-1738
Fax: 717-646-7430

UPMC Heart and Vascular Institute
16324 Mount Airy Road
Lower Level
Shrewsbury, PA 17361
Phone: 717-849-5576
Fax: 717-718-9972

UPMC Heart and Vascular Institute
1600 6th Avenue
Suite 105
York, PA 17403
Phone: 717-849-5576
Fax: 717-718-9972 

UPMC Heart and Vascular Institute
1555 Highlands Drive
Suite 100
Lititz, PA 17543
Phone: 717-299-5000
Fax: 717-431-1205 

UPMC Heart and Vascular Institute (formerly Cardiac Consultants)
1697 Crown Avenue
Suite 100
Lancaster, PA 17601
Phone: 717-299-5000
Fax: 717-431-1205