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NHS Choices - Recovering from pacemaker implantation FAQs
(30/12/2013)
- How will I be monitored?
- Will I be in pain after the procedure?
- When can I leave hospital?
- How soon can I drive?
- Will I be able to feel or see the pacemaker?
- How soon will I be back to normal?
- When can I do exercise or play sports again?
- How can I care for my wound?
- Will I have to have my stitches removed?
- What check-ups will I need?
- What problems should I look out for?
- Will my pacemaker be affected by electrical equipment?
- Will I need to have another pacemaker?
- How often will I need a follow-up?
- Will my sex life be affected?
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.
When can I leave hospital?
Although it is sometimes possible to go home the same day you have the procedure, you will usually need to stay in hospital for one or two days.
You will need to arrange for someone to pick you up from hospital and take you home.
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, 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 & 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 six weeks after your pacemaker is fitted before driving again.
Will I be able to feel or see 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.
Modern pacemakers are now so small that they are almost completely hidden by the chest tissue and are barely noticeable.
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 to six 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.
The time you need off work will depend on your job – your cardiologist will usually be able to advise you about this. Typically, people who have had a pacemaker fitted are advised to take three to seven days off.
When can I exercise or play sports again?
Avoid strenuous activities for around four to six 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.
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 about seven to 10 days.
What check-ups will I need?
You will usually have your pacemaker checked after four to six weeks at the hospital where it was implanted. Provided this check is satisfactory, you will have your pacemaker checked every three 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.
What problems should I look out for?
Signs that your pacemaker is not working as it should, or that you have developed an infection or blood clot, can include:
- breathlessness
- dizziness
- fainting
- prolonged weakness
- swollen arm on the side of the pacemaker
- chest pains
- prolonged hiccups
- a high temperature of 38°C (100.4°F) or above
- pain, swelling and redness at the site of the pacemaker
If you experience any of these problems after having a pacemaker fitted, contact your GP or cardiologist as soon as possible for advice.
If this is not possible, call NHS 111 or your local out-of-hours service.
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.
- Security devices – 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 scans – you must not have an MRI scan as it uses strong magnets. "MRI-safe" pacemakers do exist, but they are not currently widely used. Other scans are safe.
- 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 six to 10 years. After this, you may 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 three 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 pulse generator. Your pacemaker can then be reprogrammed to the best settings for you, if necessary.
Will my sex life be affected?
There is no reason you cannot continue to have a good sex life after your pacemaker is implanted and you're feeling better, although you should avoid positions that place pressure on the arms and chest for the first four weeks of your recovery.
Talk to your partner about any worries you may have, such as 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 desire, so use your imagination.
The risk of sex triggering a heart attack is low (around 1 in 1 million).
