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Heart Disease Health Center

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Heart Disease and Pacemakers

What Should I Do Before Getting a Pacemaker?

Ask your doctor what medications you are allowed to take before getting a pacemaker implanted. Your doctor may ask you to stop taking certain drugs one to five days before the procedure. If you have diabetes, ask your doctor how you should adjust your diabetes medications.

  • Do not eat or drink anything after midnight the evening before the procedure. If you must take medications, take them only with a small sip of water.
  • When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry and valuables at home.

How Are Pacemakers Implanted?

Pacemakers are implanted two ways:

  • Endocardial approach. This is the most common technique used.
    • This procedure is performed in a pacemaker or electrophysiology lab.
    • A local anesthetic (pain-relieving medication) is given to numb the area. An incision is made in the chest where the leads and pacemaker are inserted.
    • The lead(s) is inserted through the incision and into a vein, then guided to the heart with the aid of the fluoroscopy machine.
    • The lead tip attaches to the heart muscle, while the other end of the lead (attached to the pulse generator) is placed in a pocket created under the skin in the upper chest.
  • Epicardial approach. This technique is more commonly used in children.
    • This procedure is performed by a surgeon in a surgical suite. General anesthesia is given to put you to sleep.
    • The surgeon attaches the lead tip to the heart muscle, while the other end of the lead (attached to the pulse generator) is placed in a pocket created under the skin in the abdomen.
    • Although recovery with the epicardial approach is longer than that of the other approach, minimally invasive techniques have enabled shorter hospital stays and quicker recovery times.

The doctor will determine which pacemaker implant method is best for you.

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