Your doctor will arrange a date for you to be admitted to the hospital. Usually you are admitted on the day of the procedure; occasionally, you will be admitted the day before. Most patients can expect to be discharged the following day; occasionally, your hospital stay may be longer if the procedure is difficult or complicated.
Your doctor should already have instructed you on what to do before the procedure.
Please check with your doctor before discontinuing any medications. The following information is a general guide only.
If you are on warfarin, this will normally need to be discontinued around 5 days prior to the procedure, and a blood test (“INR”) taken to confirm that your blood clotting is normal prior to implantation. Please check with your doctor before discontinuing your medications.
If you are taking aspirin or clopidogrel (Plavix), you may be asked to discontinue one or both of these prior to implantation; however, please confirm this with your doctor.
You can normally continue taking your other medications as usual.
If you have diabetes, liase with the nurse to adjust your diabetic medications or insulin accordingly.
In most cases, you will be told to eat a normal meal the evening before your procedure. However, do not eat, drink or chew anything after 12 midnight before your procedure. This includes gum, mints, water, etc. If you must take medications, only take them with small sips of water. When brushing your teeth, do not swallow any water.
When getting ready, please do not wear makeup and remove nail polish. Wear comfortable clothes when you come to the hospital. You will change into a hospital gown for the procedure. Please leave all jewelry (including wedding rings), watches and valuables at home.
Before the procedure begins, a nurse will help you get ready. You will be given a hospital gown to change into. You may keep your clothes in a locker or you may give them to a family member.
You will lie on a bed and the nurse will start an IV (intravenous) line in a vein in your arm or hand. The IV is used to deliver medications and fluids during the procedure.
To prevent infection and to keep the device insertion site sterile:
In rare cases, when the endocardial approach cannot be used, the epicardial (surgical) approach is used (more common in children). With this approach, general anesthesia is given to put you to sleep during the procedure and the generator is placed in a pocket created under the skin in the lower abdomen.
The hospital recovery time is generally 3 to 5 days with the epicardial approach, although minimally invasive techniques may be used to allow a shorter hospital stay and quicker recovery time.
The doctor will determine which pacemaker implant method is best for you.