11 Pacemaker Questions Answered by a Former Telemetry Nurse
- Yhaimar Barile
- Jul 17
- 9 min read
In this article:
Your primary care doctor told you that you needed to see a cardiologist due to your heart issues. After seeing the cardiologist, they informed you that you require a pacemaker. The thought of having surgery may sound daunting, but let's discuss it further.
1. What is a pacemaker and why do I need one?
A pacemaker is a small device that helps your heart beat normally. You need surgery to put it under your skin. The pacemaker sends electric signals to your heart to keep it beating at a normal pace.
Doctors recommend pacemakers for people whose hearts don't beat normally. The pacemaker works only when it senses a problem with the heartbeat. Some common problems that might need a pacemaker are:
Bradycardia: The heart beats too slowly because of an electrical impulse problem.
Tachy-brady syndrome: The heart switches between beating too fast and too slow.
Heart block: The electrical signals to your heart get delayed or blocked. There are different types of heart blocks.
Problems with the heart's rhythm can make it hard for the heart to pump blood around the body. If the heart beats too slow, the blood moves slow. If the heart beats too fast or irregular, the heart chambers can't fill up with enough blood to pump out. When the body doesn't get enough blood, you might feel tired, dizzy, faint, or have chest pain.
Doctors call a pacemaker a different name like cardiac pacing device.
2. How does a pacemaker work?
Your heart has a natural pacemaker called the sinus node, located in the top right chamber of your heart. This small area has special cell that send electrical messages making your heart beat. If there’s a problem with your sinus node, your heartbeat may be too slow, too fast, or not beat regularly. If there is a problem with your natural pacemaker, an artificial pacemaker can help monitor your heartbeat.
When there’s a problem with your heart rate, the pacemaker works like this:
Sensors at the end of the wires connected to your heart detect abnormal heartbeats.
The pacemaker has a sensor that turns off if your heartbeat is too fast.
If your heartbeat is slower than the rate the pacemaker is set to, the sensor turns the pacemaker back on.
The pacemaker sends a small electrical signal to your heart to fix the rhythm back on track.
The pacemaker only turns on when it needs to. If your heart is beating normally, it stays off.
Traditional pacemakers use wires (leads) to send messages directly to your heart. Newer wireless pacemakers go right inside your heart with no wires. Either way, a pacemaker help keep your heart beating at a steady rhythm, so you can feel better and stay active.
3. How is a pacemaker implanted?
The doctor will order some tests to see if you need a pacemaker. If they say you do, you'll need surgery. This usually takes place at the hospital or a special procedure room and takes a few hours. You’ll get medicine to help you relax and numb the area, so you shouldn’t feel pain.
During the procedure, the doctors will:
Make a small cut (surgical site) below your collarbone
Create a pocket under your skin to hold the pacemaker device
Thread the wires (leads) through the catheter into your heart
Connect the wires in the heart to the pacemaker
Place the pacemaker under your skin and close the incision with stitches and glue
You may be awake during the surgery, but you’ll be relaxed through the entire procedure. If you get a wireless pacemaker, doctors place it directly inside your heart through a vein, so you don’t need wires under your skin.
4. What are the risks or complications of pacemaker surgery?
Pacemaker surgery is generally safe, but like any medical procedure, it has some risks. Most complications are rare, and doctors can manage them if they find the problem early. These problems can happen either at the surgical site, the catheter insertion site, or both areas. It’s important to talk to your doctor about your specific risks before the surgery.
Possible Risks and Complications:
Bleeding from the surgery site (the incision under your collarbone) or from the catheter site (where the tube enters your blood vessel)
Damage to the blood vessel at the catheter insertion site
Infection at the incision (surgical) site or at the catheter site
Pneumothorax which is air leaking into the space around the lung. This trapped air can cause breathing problems or, rarely, make your lung collapse
Discomfort or pain from lying still during the procedure
Other things to keep in mind are:
Let your healthcare team know if you are pregnant, think you may be pregnant, or if you are breastfeeding.
Tell your doctor if you have allergies or sensitivities to medications or latex.
There may be other risks they have to do with your specific health conditions, so always discuss your medical history and concerns with your doctor.
5. How long will I stay in the hospital after getting a pacemaker?
You will likely stay in the hospital for several hours or overnight after the pacemaker surgery. This allows the care team to monitor your heart, check your incision, and make sure the pacemaker is working well. They also program the pacemaker to meet your heart’s specific needs.
The surgery site may swell, be painful, or sore. The care team may give you pain medications to treat the discomfort. Your doctor may check on you and answer any questions. If you feel well and there are no complications, you may likely go home the next day. Make sure to arrange for someone to drive you home from the hospital.
6. How do I care for the incision at home?
Your doctor will give you detailed instructions on when you can return to normal activities, including work and driving. They will also explain any restrictions related to bathing, showering, and your diet. It’s important to follow all instructions closely to for a smooth recovery.
Here are some general after surgery instructions your doctor may give you:
Keep the incision clean and dry
Follow your doctor’s instructions about when you can shower or bathe
Do not lift your arm above your shoulder on the side of your pacemaker until your doctor says it’s okay
Resume your usual diet unless you are told otherwise
Ask your doctor when it is safe to return to work; this depends on your job, health, and recovery progress
Your doctor will give you specific instructions about when you can drive
It is important to watch for some warning signs and contact your doctor immediately if you experience any of these:
Fever and/or chills
More redness, swelling, pain, bleeding, drainage, or from the surgery site
Chest pain or pressure
Nausea or vomiting
Dizziness, heavy sweating, or fainting
Palpitations (irregular or fast heartbeat)
Following your care, instructions and staying alert to possible warning signs can help ensure a safe recovery after a pacemaker surgery.
7. What will life be like with my pacemaker?
Most people get back to normal routine within a few weeks after pacemaker surgery. Once you've recovered, you'll usually be able to do most the same activities you enjoyed before. Your doctor will let you know when to get back to walking, traveling, working, or exercising.
Here's what to expect in daily life with a pacemaker:
After a few weeks, you can go back to most daily activities, including walking, light exercise, and travel
For the first 3-6 weeks, avoid heavy lifting and intense workouts
Avoid raising the arm on the side of your pacemaker over your shoulder level for 4-6 weeks
You might feel a small bump under your skin where the pacemaker is, but that's normal
Continue to take your pulse regularly if your doctor recommends it
Keep taking your medications as the doctor prescribed
Keep all the follow up appointments your doctor instructed
Always inform your doctors, dentists, and all medical staff you have a pacemaker. This is important especially before any surgery, procedures, or tests like Magnetic Resonance Imaging (MRI)
Always carry your pacemaker ID card and consider wearing a medical ID bracelet.
When traveling, tell airport security you have a pacemaker before screening. Ask the staff not to hold the scanner directly over your device
Most household appliances are safe to use, like microwaves and hair dryers.
It’s important to be cautious around devices that may interfere with your pacemaker. Your doctor will give you more details depending on your specific device and health needs.
8. What equipment and devices are safe to use with a pacemaker?
You can safely use most everyday household electronics and appliances with a pacemaker. These include:
Microwave ovens
Kitchen appliances
Hair dryers
Hot tubs
Massage chairs or pads
Computers, tablets, e-readers, printers, photocopiers
TVs and remote controls
Electric shavers
Electric blankets
Wi-Fi routers and Bluetooth devices
Video game controllers
Garage door openers
Electric lawn mowers, weed trimmers, leaf blowers
Power tools like electric drills, power saws, sanders
Stud finders
Metal detectors
These devices normally do not interfere with your pacemaker function, so you can use them as you normally would. However, you should always keep the electrical motor 6 inches away from your pacemaker. Talk to your doctor if you are not sure how to use a specific device safely.
9. What should I avoid with a pacemaker?
While most everyday items are safe, some devices can interfere with your pacemaker if they get too close. These can affect how the pacemaker works. To stay safe, follow these precautions:
Cell Phones: Keep your cell phone at least 6 inches away from your pacemaker. Use the ear opposite your device. Avoid carrying your phone in a chest pocket over your pacemaker.
Headphones: Keep headphones and earbuds at least 6 inches from your pacemaker. Don’t drape them around your neck or let someone rest their head with headphones on your chest.
Magnets: Avoid close or long contact with magnets, including magnetic therapy products, magnetic pillows, and mattress pads. Keep all magnets at least 6 inches away from your pacemaker. Avoid strong magnets and large electrical devices, like industrial magnets, MRI machines (unless your device is MRI-safe), and power generators.
Metal detectors and security systems: Walk through security gates and metal detectors at a normal pace. Don’t linger near or lean against them. If a handheld metal detector is used, ask security not to hold it over your pacemaker.
Radios: Most household radios are safe but keep citizen’s band (CB) or “ham” radios under 3 watts at least 6 inches away. You should keep higher-powered radios farther away.
Portable car batteries: Keep them at least 12 inches away from your pacemaker.
If you work in environments with high-voltage equipment or strong magnetic fields, check with your doctor for specific advice. Following these tips are important to keep your pacemaker working well and avoid problems.
10. When can i return to normal activities, and what will physical activity look like?
After your pacemaker procedure, your body needs time to heal. Your doctor will say when it's okay to get back to your normal routine. As you recover, increase your activity, but always follow your doctor's guidance.
You may get some instructions on physical activity after pacemaker surgery:
Do not raise the arm on the pacemaker side above your shoulder until your doctor says it’s okay
Avoid lifting heavy objects (over 10 pounds) with the arm on the pacemaker side for a few weeks
Be careful to protect your chest from any bumps, impact, trauma, or blows, especially when playing sports or doing recreational activities
Do not push, pull, or do intense upper body exercises until your doctor approves
Go for daily walks and light activity as recommended. Stop if you feel tired or unwell
Always check with your doctor before trying any new workouts or activities. They'll let you know what's safe for you.
11. How long does a pacemaker last and how is it checked?
Pacemaker batteries usually last 10 to 15 years. The battery life depends on the type of device and how much use it gets. Your doctor will check your device every six months or once a year to make sure it’s working well.
When the battery runs low, you’ll need a minor procedure to replace the pacemaker’s battery or the device itself.
You should immediately call your doctor if you feel any of these symptoms:
· Chest pain
· Trouble breathing
· Feel dizzy or fainting
· Frequent hiccups
· Fatigue
· Swelling in your ankle
These symptoms could be warning signs your pacemaker isn’t working properly. You should always have your pacemaker ID card in your wallet or purse so emergency medical team s know you have a pacemaker.
Pacemaker surgery is a common and safe procedure that helps your heart beat more effectively. If you have more questions about your pacemaker surgery, ask your healthcare team or visit trusted sources like the American Heart Association.
Sources
American Heart Association:
Cleveland Clinic:
Johns Hopkins Medicine:
Assessed and Endorsed by the MedReport Medical Review Board