Post-pacemaker instructions

What to expect

You were in the hospital to have a Permanent Pacemaker (PPM) put in. A pacemaker is a small, battery-operated device that can tell when your heart is beating irregularly or too slowly. It sends a signal to your heart to make sure that your heartbeat is never too slow

Follow these important instructions:

Pacemaker identification (ID)

Carry your pacemaker ID card with you at all times. You will be given a temporary card before you leave the hospital. Your permanent card will be sent from the manufacturer within 6–8 weeks.

Incision care

• Keep your wound clean and dry. 
• If steri-strips were placed, leave the white paper steri-strips in place. You should remove them after 10 days.
• Do not scratch or pick at the glue over the wound site. It will peel off on its own. Do not cover with a dressing.
• You may shower 48 hours after your surgery. Do not put soap or lotion on your incision, and do not cover your incision with tape or bandages. 
• When you shower, just let water run over it. Do not submerge your incision in a bath, hot tub, pool, or other body of water for four weeks.
• Please contact your physician or nurse if:
  • You develop drainage, redness or swelling at  the incision site
  • You develop marked tenderness or bruising over the pacemaker site and it does not resolve
  • You develop a fever over 101.5° F

Medicines and anticoagulation

• Take your heart medicines every day the way you are told to on your Discharge Medicine List. Do NOT stop taking your medicines. Call your doctor if they are not helping or if you have side effects.
• Ok to apply ice to wound site.
• Use Tylenol every six hours for pain as needed.
• If you take Coumadin or Jantoven, you should restart as prescribed. You should have your next blood test (INR) as previously scheduled.
  • It is very important that your INR stays in range. This will make sure that your blood is not getting too thin which can cause bleeding around your pacemaker.
  • Eat the same amount of vitamin K each day. Vitamin K is found in leafy green vegetables such as spinach and kale. Changing how much vitamin K you eat can change how much warfarin you need.
• You should restart your Pradaxa (dabigatran), Xarelto (rivaroxaban), Eliquis (apixaban) as scheduled. No blood tests are necessary for these medications.

Activity

• Avoid rough contact with your pacemaker.
• No vigorous activity with your affected arm (left or right), keep your elbow below your shoulder for four weeks, but please mobilize your joint to avoid shoulder injury like frozen shoulder.
• Avoid strenuous activities, such as golf and tennis for six weeks.
• Do not lift more than 10 pounds with the affected arm. Ten pounds is as heavy as one gallon of milk.
• You may restart sexual activity.

Other instructions

• Please remind dentists and other physicians that you have a pacemaker
• You will be automatically enrolled in a pacemaker monitoring program. This program is done over the telephone or wirelessly. You will be given a monitor and instructions.
  • The pacemaker monitoring program is important for your care.
  • It does not replace regular office visits with your doctor.
• Avoid strong electromagnetic fields as they may interfere with the pacemaker (i.e., airport security scanner and electronic security devices)
• If your device is MRI compatible, you can have an MRI, however please do not do so until after 6 weeks from your pacemaker implant date. Your pacemaker may need to be reprogrammed before and after your MRI to put it in an MRI safe mode.
• If your device is not MRI compatible, please avoid MRI scanners.
• Encourage your family members to learn CPR. Call the American Heart Association CPR Hotline at 800.242.8271 for information about a class near you.

Post-sedation care

You have received sedative medication(s) which can affect your judgment and coordination. For the next 24 hours:

• Do not operate heavy machinery
• Do not drive a car
• Do not consume alcohol
• Do not make important decisions

You must be accompanied by a responsible adult. Please arrange to have a friend or relative to take you home. It is strongly recommended that you have someone stay with you for the next 12 hours.

Radiation exposure care

You were in the hospital for a procedure that used X-rays. An X-ray is a test that takes pictures of the inside of your body. To do this, the X-ray machine uses radiation, which is a kind of energy. It does not happen often, but being exposed to radiation can cause side effects.

Follow these important instructions below:

• For two weeks after your procedure, watch for side effects from the radiation.
• Side effects are sunburn and redness or rash over your chest, back, arms, backside or legs