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Our Approach for Pacemakers
If your heart rate is too slow, you may need a pacemaker. These devices stimulate the heart to beat at a normal rate and pump more effectively.
Our electrophysiologists at Stanford use the latest advancements in pacemaker technology. We offer comprehensive care from a team of highly skilled experts who are leading the field in research and patient care for all types of arrhythmias.
WHAT WE OFFER YOU FOR PACEMAKER
- Nationally recognized expertise in pacemaker programming and device management to tailor treatment to your specific needs.
- Remote device monitoring by our device nurses, who can monitor your pacemaker and address any issues as soon as they arise—meaning fewer office visits.
- One convenient location with our device clinic, catheterization lab, and other care areas for all your care—from evaluation to procedure to follow-up—in one place.
- Support services for all aspects of your care, including device management, support groups, and individual counseling for people living with a pacemaker.
- Thought leadership by Stanford doctors who publish articles and textbooks to train other electrophysiologists in the latest pacemaker advances.
To request an appointment with one of our arrhythmia specialists, call: 650-723-7111.
What is a Pacemaker?
Types of Pacemakers
The type of pacemaker you may need depends on your symptoms and the specific heart condition you have. After our diagnostic evaluation, we discuss our recommendations with you to choose the right pacemaker for your needs.
Single-chamber pacemaker
This type of pacemaker has one lead that connects the pulse generator to one chamber of your heart.
For most people, we use the single-chamber pacemaker to control heartbeat pacing by connecting the lead to your right ventricle (lower heart chamber). Depending on your symptoms and the type of pacing you need, we connect the lead to your right atrium (upper heart chamber) to stimulate the pacing in that chamber.
Dual-chamber pacemaker
With two leads, this device connects to both chambers on the right side of your heart, the right atrium and the right ventricle. The doctor programs the dual-chamber pacemaker to regulate the pace of contractions of both chambers.
This pacemaker helps the two chambers work together, contracting and relaxing in the proper rhythm. The contractions allow blood to flow properly from the right atrium into the right ventricle.
Depending on the pacing needs of your heart, a dual-chamber device may be an appropriate option for you.
Biventricular pacemaker
This pacemaker, also known as a cardiac resynchronization therapy (CRT) device, has three leads connected to the right atrium and both ventricles. We use the biventricular pacemaker to treat people with arrhythmias caused by advanced heart failure.
For many people with heart failure, the left and right ventricles do not pump at the same time. Our doctors program the biventricular pacemaker to coordinate the contractions of the ventricles, so that they both pump together.
Coordinating the ventricles’ contractions helps your heart pump blood more efficiently and can relieve your heart failure symptoms. The treatment is known as cardiac resynchronization therapy because it resynchronizes the ventricles’ pumping action.
What to Expect
Implanting the pacemaker requires a minor surgical procedure performed in the cardiac catheterization laboratory.
Before
During
After
Before the Procedure
Your doctor will discuss the implantation with you prior to the procedure. Once you and your doctor have discussed the procedure and you've had any questions answered, you'll be asked to sign an informed consent form.
You won't be allowed to eat or drink for eight hours prior to the procedure.
We will instruct you if you need to stop any medications before the procedure.
During the Procedure
A pacemaker implantation procedure may be performed on an outpatient basis or as part of a stay in a hospital. Procedures may vary depending on a patient’s condition and the doctor's practices. The entire procedure usually lasts about two hours.
During the procedure, patients will lie flat on a table for the duration of the implantation. The upper chest will be scrubbed and shaved (if needed) and patients will be covered with sterile sheets.
Patients will receive some sedation intravenously to help with relaxation during the procedure.
The doctor will give a local anesthetic to numb the skin and tissue at the site of the pacemaker implantation. After the area is numb, the doctor will guide the leads through the vein and into the heart's right-side chambers using fluoroscopy (X-ray monitors).
Access to the vein under the collar bone is obtained and one or more leads (thin wire-like tubes) are advanced to the heart. The leads are connected to the pacemaker and closed under the skin.
Once the lead has been positioned, the doctor will make a two- to three-inch incision in the skin, creating a small "pacemaker pocket." The leads will be connected to the pulse generator, which is then placed into the pocket. The doctor will suture the incision over the pacemaker and place a dressing over it.
Pacemaker Insertion Process
Generally, a pacemaker insertion follows this process:
- Patients will be asked to remove any jewelry or other objects that may interfere with the procedure
- Patients will be asked to remove clothing and will be given a gown to wear
- Patients will be asked to empty their bladder prior to the procedure
- An intravenous (IV) line will be started in the hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed
- Patients will be placed in a supine (on back) position on the procedure table
- Patients will be connected to an electrocardiogram (ECG or EKG) monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. Vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored during the procedure
- Large electrode pads will be placed on the front and back of the chest
- Patients will receive a sedative medication in IV before the procedure to help patients relax. However, patients will likely remain awake during the procedure
- The pacemaker insertion site will be cleansed with antiseptic soap
- Sterile towels and a sheet will be placed around this area
- A local anesthetic will be injected into the skin at the insertion site
- Once the anesthetic has taken effect, the doctor will make a small incision at the insertion site
- A sheath, or introducer, is inserted into a blood vessel, usually under the collarbone. The sheath is a plastic tube through which the pacemaker lead wire will be inserted into the blood vessel and advanced into the heart
- It will be very important for patients to remain still during the procedure so that the placement will not be disturbed and to prevent damage to the insertion site
- The lead wire will be inserted through the introducer into the blood vessel. The doctor will advance the lead wire through the blood vessel into the heart
- Once the lead wire is inside the heart, it will be tested to verify proper location and that it works. There may be one, two, or three lead wires inserted, depending on the type of device the doctor has chosen for the patient’s condition. Fluoroscopy, (a special type of X-ray that will be displayed on a TV monitor), may be used to assist in testing the location of the leads
- Once the lead wire has been tested, an incision will be made close to the location of the catheter insertion (just under the collarbone). Patients will receive local anesthetic medication before the incision is made
- The pacemaker generator will be slipped under the skin through the incision after the lead wire is attached to the generator. Generally, the generator will be placed on the non-dominant side. (If patients are right-handed, the device will be placed in the upper left chest. If patients are left-handed, the device will be placed in the upper right chest)
- The ECG will be observed to ensure that the pacer is working correctly
- The skin incision will be closed with sutures, adhesive strips, or a special glue
- A sterile bandage/dressing will be applied
After the Procedure
If the procedure is performed on an outpatient basis, patients may be allowed to leave after completing the recovery process. However, if there are concerns or problems with the ECG, patients may stay in the hospital for an additional day (or longer) for monitoring of the ECG.
Patients should be able to return to their daily routine within a few days. The doctor will tell you if you will need to take more time in returning to normal activities. In addition, patients should not do any lifting or pulling on anything for a few weeks. Patients may be instructed not to lift arms above the head for a certain period.
Patients will most likely be able to resume their usual diet, unless the doctor instructs differently.
Change the dressing over the PM incision site daily:
- Remember to wash your hands before and after changing the dressing
- Remove the dressing from your incision and look at it carefully in a mirror
- If you have steri-strips, do not remove them (the steri-strips will be removed at your two-week incision check-up)
- Replace the dressing with a clean dressing (dressing materials should be provided to you before your discharge)
Notify the Stanford Cardiac Arrhythmia Service at (650) 723-7111 for the following:
- Infection - swelling, redness, or warmth around the incision; significant pain when touched; yellowish, greenish, or bloody discharges on your dressing or on the incision; foul smell
- Bleeding - blood oozing from the incision or PM site has become swollen or enlarged and feels tense (bleeding beneath the skin)
- Fever - if you are feeling excessively warm or have chills and your temperature is greater than 100 F (37.8 C)
If you notice signs of infection or bleeding on your incision site and seek medical attention, do not let anyone insert a needle into the area around the device to remove or collect fluid as this may result in an infection.
Sponge bath only for the first 5 days following the PM implantation.
- Showers can be done after the fifth day, unless otherwise instructed by your doctor
- The incision site can get wet; do not cover the incision with plastic wrap while showering
- Do not rub directly over the incision site or use a wash cloth, but let the water or soapy water flow
- Do not submerge your incision site in the tub, pool, hot tub or lake until it is well healed (at least 7 days)
- Avoid using deodorants, powders, creams, lotions, etc. on your incision site
- You can use a clean towel to pat dry the incision site. Do not rub while drying
Activity on the side of the pacemaker should be limited for 4-6 week (six weeks recommended for biventricular pacemaker) as follows:
- Do not lift the elbow that is on the side of your pacemaker above the shoulder. Movement of the large shoulder muscle could cause the lead inside of the heart to move out of position. Repositioning of the leads will require another surgical procedure.
- Do not participate in any activities that require forceful large arm movements, such as basketball, swimming, golf, and vacuuming
- Do not lift anything over 10 pounds
- We recommend walking for at least 30 minutes, five days a week. You may increase your activities slowly and resume your usual level of activity after 6 weeks
- If you have additional questions about activities and exercise, please discuss them with us.
Driving should be discussed on an individual basis with your doctor.
Cover the pacemaker site if in direct sunlight as the metal of the device will warm beneath the skin.
Electromagnetic fields can interfere with the pacemaker's ability to sense an abnormal rhythm. Some devices and machines are safe to use while other devices are not:
- Microwave ovens, computers, VCRs, small electrical tools, and garage door openers are all safe to use
- Avoid devices or areas that have strong electric or magnetic fields such as: leaning over a car engine while it is running, running motorcycle engines, power plants, ham radios, etc.
- Cellular phones, MP3 players, and headphones should be held at least 6 inches away from your pacemaker. Hold the phone on the ear opposite your pacemaker and avoid keeping your phone and headphones in a pocket on top of your pacemaker. Avoid resting your head on the chest of a person with a pacemaker while wearing headphones
- When traveling in the airport, tell security you have a pacemaker and request for a hand search instead of walking through the metal detector. The metal detector will not harm the pacemaker but it may set off the alarm. Limit scanning with a hand-held metal detector over the device no longer than necessary.
- Inform your health care provider that you have a pacemaker before they perform any test or procedure using medical or electronic devices.
- If you are to undergo dental procedures or any type of surgery involving electrocautery, have your dentist/physician contact either the device manufacturer or us. The electrocautery might be misinterpreted by the pacemaker as heart beats and withhold pacing
- Normal teeth cleaning are safe and require no special instructions.
You cannot have an MRI because of the possible magnetic interference.
Carry your pacemaker identification card in your wallet at all times. You will be given a temporary card upon discharge. A permanent card will be mailed to you from the pacemaker manufacturer in 6-8 weeks.
We suggest that you wear a Medic Alert Emblem. Please ask for the form if you have not been given one.
Please notify your pacemaker manufacturer if you have a new address or phone number. Their toll-free phone number is on the temporary and permanent identification card.
It is very important that you have your pacemaker checked regularly (4 to 6 weeks after implant and every 6 months thereafter).
Need to schedule an appointment? Please call Cardiac Arrhythmia Service at 650-723-6459.
It is recommended that you know your pacemaker parameters. We will tell you what heart rate your pacemaker parameters and answer any questions that you may have regarding your device programming upon discharge or during your first clinic visit for a wound check or device check.
Some devices are equipped with remote monitoring capabilities where you can send information about your pacemaker from home that the clinic can view. We recommend that you have this capability for your routine device surveillance. We will discuss with you at your clinic visit.
Symptoms - Medical emerygency
You should lie down immediately, make sure you are in a safe environment, away from any machines or moving vehicles, and call a friend or family member, or call 911, if you feel any of the following symptoms:
- Lightheadedness
- Fast heart rate (palpitations)
- Dizziness
- Chest pain
- Shortness of breath
- Fainting or near fainting (syncope)
Important Phone Numbers:
Stanford Arrhythmia Service: (650) 723-7111 - for questions or problems (available 24 hours a day, 7 days a week)
Stanford Device Clinic: (650) 723-6459 - for appointments
Before the Procedure
Your doctor will discuss the implantation with you prior to the procedure. Once you and your doctor have discussed the procedure and you've had any questions answered, you'll be asked to sign an informed consent form.
You won't be allowed to eat or drink for eight hours prior to the procedure.
We will instruct you if you need to stop any medications before the procedure.
close Before
During the Procedure
A pacemaker implantation procedure may be performed on an outpatient basis or as part of a stay in a hospital. Procedures may vary depending on a patient’s condition and the doctor's practices. The entire procedure usually lasts about two hours.
During the procedure, patients will lie flat on a table for the duration of the implantation. The upper chest will be scrubbed and shaved (if needed) and patients will be covered with sterile sheets.
Patients will receive some sedation intravenously to help with relaxation during the procedure.
The doctor will give a local anesthetic to numb the skin and tissue at the site of the pacemaker implantation. After the area is numb, the doctor will guide the leads through the vein and into the heart's right-side chambers using fluoroscopy (X-ray monitors).
Access to the vein under the collar bone is obtained and one or more leads (thin wire-like tubes) are advanced to the heart. The leads are connected to the pacemaker and closed under the skin.
Once the lead has been positioned, the doctor will make a two- to three-inch incision in the skin, creating a small "pacemaker pocket." The leads will be connected to the pulse generator, which is then placed into the pocket. The doctor will suture the incision over the pacemaker and place a dressing over it.
Pacemaker Insertion Process
Generally, a pacemaker insertion follows this process:
- Patients will be asked to remove any jewelry or other objects that may interfere with the procedure
- Patients will be asked to remove clothing and will be given a gown to wear
- Patients will be asked to empty their bladder prior to the procedure
- An intravenous (IV) line will be started in the hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed
- Patients will be placed in a supine (on back) position on the procedure table
- Patients will be connected to an electrocardiogram (ECG or EKG) monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. Vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored during the procedure
- Large electrode pads will be placed on the front and back of the chest
- Patients will receive a sedative medication in IV before the procedure to help patients relax. However, patients will likely remain awake during the procedure
- The pacemaker insertion site will be cleansed with antiseptic soap
- Sterile towels and a sheet will be placed around this area
- A local anesthetic will be injected into the skin at the insertion site
- Once the anesthetic has taken effect, the doctor will make a small incision at the insertion site
- A sheath, or introducer, is inserted into a blood vessel, usually under the collarbone. The sheath is a plastic tube through which the pacemaker lead wire will be inserted into the blood vessel and advanced into the heart
- It will be very important for patients to remain still during the procedure so that the placement will not be disturbed and to prevent damage to the insertion site
- The lead wire will be inserted through the introducer into the blood vessel. The doctor will advance the lead wire through the blood vessel into the heart
- Once the lead wire is inside the heart, it will be tested to verify proper location and that it works. There may be one, two, or three lead wires inserted, depending on the type of device the doctor has chosen for the patient’s condition. Fluoroscopy, (a special type of X-ray that will be displayed on a TV monitor), may be used to assist in testing the location of the leads
- Once the lead wire has been tested, an incision will be made close to the location of the catheter insertion (just under the collarbone). Patients will receive local anesthetic medication before the incision is made
- The pacemaker generator will be slipped under the skin through the incision after the lead wire is attached to the generator. Generally, the generator will be placed on the non-dominant side. (If patients are right-handed, the device will be placed in the upper left chest. If patients are left-handed, the device will be placed in the upper right chest)
- The ECG will be observed to ensure that the pacer is working correctly
- The skin incision will be closed with sutures, adhesive strips, or a special glue
- A sterile bandage/dressing will be applied
close During
After the Procedure
If the procedure is performed on an outpatient basis, patients may be allowed to leave after completing the recovery process. However, if there are concerns or problems with the ECG, patients may stay in the hospital for an additional day (or longer) for monitoring of the ECG.
Patients should be able to return to their daily routine within a few days. The doctor will tell you if you will need to take more time in returning to normal activities. In addition, patients should not do any lifting or pulling on anything for a few weeks. Patients may be instructed not to lift arms above the head for a certain period.
Patients will most likely be able to resume their usual diet, unless the doctor instructs differently.
Change the dressing over the PM incision site daily:
- Remember to wash your hands before and after changing the dressing
- Remove the dressing from your incision and look at it carefully in a mirror
- If you have steri-strips, do not remove them (the steri-strips will be removed at your two-week incision check-up)
- Replace the dressing with a clean dressing (dressing materials should be provided to you before your discharge)
Notify the Stanford Cardiac Arrhythmia Service at (650) 723-7111 for the following:
- Infection - swelling, redness, or warmth around the incision; significant pain when touched; yellowish, greenish, or bloody discharges on your dressing or on the incision; foul smell
- Bleeding - blood oozing from the incision or PM site has become swollen or enlarged and feels tense (bleeding beneath the skin)
- Fever - if you are feeling excessively warm or have chills and your temperature is greater than 100 F (37.8 C)
If you notice signs of infection or bleeding on your incision site and seek medical attention, do not let anyone insert a needle into the area around the device to remove or collect fluid as this may result in an infection.
Sponge bath only for the first 5 days following the PM implantation.
- Showers can be done after the fifth day, unless otherwise instructed by your doctor
- The incision site can get wet; do not cover the incision with plastic wrap while showering
- Do not rub directly over the incision site or use a wash cloth, but let the water or soapy water flow
- Do not submerge your incision site in the tub, pool, hot tub or lake until it is well healed (at least 7 days)
- Avoid using deodorants, powders, creams, lotions, etc. on your incision site
- You can use a clean towel to pat dry the incision site. Do not rub while drying
Activity on the side of the pacemaker should be limited for 4-6 week (six weeks recommended for biventricular pacemaker) as follows:
- Do not lift the elbow that is on the side of your pacemaker above the shoulder. Movement of the large shoulder muscle could cause the lead inside of the heart to move out of position. Repositioning of the leads will require another surgical procedure.
- Do not participate in any activities that require forceful large arm movements, such as basketball, swimming, golf, and vacuuming
- Do not lift anything over 10 pounds
- We recommend walking for at least 30 minutes, five days a week. You may increase your activities slowly and resume your usual level of activity after 6 weeks
- If you have additional questions about activities and exercise, please discuss them with us.
Driving should be discussed on an individual basis with your doctor.
Cover the pacemaker site if in direct sunlight as the metal of the device will warm beneath the skin.
Electromagnetic fields can interfere with the pacemaker's ability to sense an abnormal rhythm. Some devices and machines are safe to use while other devices are not:
- Microwave ovens, computers, VCRs, small electrical tools, and garage door openers are all safe to use
- Avoid devices or areas that have strong electric or magnetic fields such as: leaning over a car engine while it is running, running motorcycle engines, power plants, ham radios, etc.
- Cellular phones, MP3 players, and headphones should be held at least 6 inches away from your pacemaker. Hold the phone on the ear opposite your pacemaker and avoid keeping your phone and headphones in a pocket on top of your pacemaker. Avoid resting your head on the chest of a person with a pacemaker while wearing headphones
- When traveling in the airport, tell security you have a pacemaker and request for a hand search instead of walking through the metal detector. The metal detector will not harm the pacemaker but it may set off the alarm. Limit scanning with a hand-held metal detector over the device no longer than necessary.
- Inform your health care provider that you have a pacemaker before they perform any test or procedure using medical or electronic devices.
- If you are to undergo dental procedures or any type of surgery involving electrocautery, have your dentist/physician contact either the device manufacturer or us. The electrocautery might be misinterpreted by the pacemaker as heart beats and withhold pacing
- Normal teeth cleaning are safe and require no special instructions.
You cannot have an MRI because of the possible magnetic interference.
Carry your pacemaker identification card in your wallet at all times. You will be given a temporary card upon discharge. A permanent card will be mailed to you from the pacemaker manufacturer in 6-8 weeks.
We suggest that you wear a Medic Alert Emblem. Please ask for the form if you have not been given one.
Please notify your pacemaker manufacturer if you have a new address or phone number. Their toll-free phone number is on the temporary and permanent identification card.
It is very important that you have your pacemaker checked regularly (4 to 6 weeks after implant and every 6 months thereafter).
Need to schedule an appointment? Please call Cardiac Arrhythmia Service at 650-723-6459.
It is recommended that you know your pacemaker parameters. We will tell you what heart rate your pacemaker parameters and answer any questions that you may have regarding your device programming upon discharge or during your first clinic visit for a wound check or device check.
Some devices are equipped with remote monitoring capabilities where you can send information about your pacemaker from home that the clinic can view. We recommend that you have this capability for your routine device surveillance. We will discuss with you at your clinic visit.
Symptoms - Medical emerygency
You should lie down immediately, make sure you are in a safe environment, away from any machines or moving vehicles, and call a friend or family member, or call 911, if you feel any of the following symptoms:
- Lightheadedness
- Fast heart rate (palpitations)
- Dizziness
- Chest pain
- Shortness of breath
- Fainting or near fainting (syncope)
Important Phone Numbers:
Stanford Arrhythmia Service: (650) 723-7111 - for questions or problems (available 24 hours a day, 7 days a week)
Stanford Device Clinic: (650) 723-6459 - for appointments
close After
Frequently Asked Questions
In the past, people with pacemakers risked interference with the proper functioning of their pacemakers if they were too close to car distributors, radar, microwaves, electric blankets, and airport security detectors. However, with improvements in pacemaker technology, these issues are no longer of major concern.
The following precautions should always be considered. Discuss the following in detail with the doctor:
- Use caution when going through airport security detectors. Check with the doctor about the safety of going through such detectors with your specific pacemaker
- Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields
- Abstain from diathermy (the use of heat in physical therapy to treat muscles)
- Turn off large motors, such as cars or boats, when working on them (they may temporarily "confuse" your pacemaker's rate)
- Avoid certain high-voltage or radar machinery, such as radio or television transmitters, electric arc welders, high-tension wires, radar installations, or smelting furnaces
- If patients are having a surgical procedure performed by a surgeon or dentist, tell your surgeon or dentist that you have a pacemaker, so that electrocautery will not be used to control bleeding (the electrocautery device can change the pacemaker settings)
- Always carry an ID card that indicates patient is wearing a pacemaker
- Patients may have to take antibiotic medication before any medically invasive procedure to prevent infections that may affect the pacemaker
Always consult your doctor if you have any questions concerning the use of certain equipment near your pacemaker.
Once the pacemaker has been implanted, people with pacemakers should be able to do the same activities everyone else in their age group is doing.
Patients with a pacemaker may still be able do the following:
- Exercise moderately, upon advice from the doctor
- Drive or travel
- Return to work
- Work in the yard or house
- Participate in sports and other recreational activities
- Take showers and baths
- Continue sexual relationships
When involved in a physical, recreational, or sporting activity, a person with a pacemaker should avoid receiving a blow to the skin over the pacemaker. A blow to the chest near the pacemaker can affect its functioning. See your doctor if a blow to chest is received near the pacemaker.
Always consult with the doctor when feeling ill after an activity, or if there are questions about beginning a new activity.
Although the pacemaker is built to last several years, always check the device regularly to ensure that it is working properly.
The proper method for checking the accuracy of the pacemaker includes the following:
- Patients should their pulse regularly to make sure the pacemaker is keeping pulse at the targeted rate
- Check the "pacing lead" (the lead which sends information from the heart to the pacemaker) with an electrocardiogram (ECG) at your doctor's office. In addition, patients may participate in a telephonic checkup for the pacemaker on a periodic basis. The doctor will provide special instructions
- See the doctor regularly for check-ups
- Report any unusual symptoms or symptoms like those had prior to the pacemaker insertion to the doctor immediately
Always consult your doctor for more information, if needed.
The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood.
Taking a pulse not only measures the heart rate, but also can indicate:
- Heart rhythm (abnormal rhythm may indicate a heart disorder)
- Strength of the pulse (a weak pulse may indicate a fast heart beat in which some beats are too weak to feel, heart failure, or a low volume of blood in the circulatory system)
The normal pulse rate for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions.
Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men. Athletes, such as runners, who do a lot of cardiovascular conditioning may have heart rates in the 40s and experience no problems.
As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body. The pulse can be found on the side of the lower neck, on the inside of the elbow, or at the wrist.
When taking your pulse:
- Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse
- Begin counting the pulse when the clock's second hand is on the 12
- Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to calculate beats per minute)
- When counting, do not watch the clock continuously, but concentrate on the beats of the pulse
- If unsure about your results, ask another person to count for you
If the doctor has ordered you to check your own pulse and you are having difficulty finding it, consult your doctor for additional instruction.
Possibly, depending on the type of mobile phone being used. Today's pacemakers are engineered to withstand interference from analog cellular phones. However, in some cases, digital mobile phones may interfere with pacemakers. According to the American Heart Association, a group of mobile phone companies is studying the newer mobile phones with new frequency and their effect on pacemakers.
We recommend mobile phones should not be used directly above the pacemaker. Patients are instructed to hold their mobile phone six inches away from the pacemaker and to hold the phone to the ear opposite of the pacemaker. Patients are instructed not to keep them in the "on" position in a pocket on top of the pacemaker.
Other devices
Most electrical and mechanical devices won't interfere with the pacemaker. In general, patients may use any appliance or go anywhere except into areas where strong electrical interference may exist. Patients should always tell any doctor or dentist that they have a pacemaker.
Microwave ovens, computers, DVD players, small electric tools, and garage door openers are all safe to use.
Patients are instructed to avoid large magnetic fields such as: leaning over a car engine while it is running, running motorcycle engines, chainsaws, power plants, etc.
When traveling in the airport, patients are instructed to tell Security that they have a pacemaker and Security will hand search the patient instead of having the patient walk through the metal detector. The metal detector will not harm the pacemaker, but the patient may set off the alarm.
Patients are instructed that they cannot have an MRI done because of the possible magnetic interference.
Some pacemakers may need to be adjusted if a patient's medical condition or lifestyle changes. The doctor will instruct patients about the schedule of follow-up visits to keep based on condition and type of device. In addition, patients may participate in telephonic assessment of your device on a periodic basis.
Leads are the actual wires that carry the electrical charges to areas of the heart. If the original leads are functioning properly, in most cases, they can be left in place and reattached to the new pacemaker.
Most pacemakers will last between 8 and 10 years, after which the entire pacemaker or its battery and/or wire(s) need to be replaced. Replacing a pacemaker may be done on an outpatient basis or may include an overnight stay in the hospital.
Patients should always carry an ID card that states they are wearing a pacemaker. In addition, patients should wear a medical identification bracelet that states they have a pacemaker.
Patients will receive a pacemaker identification (ID) card while in the hospital, or in the mail after returning home. Carry this ID at all times. Patients will be given a temporary card upon discharge and a permanent card will be mailed to the patient from the pacemaker manufacturer in six to eight weeks.
Patients are given the option of wearing a Medic Alert Emblem, and may request a form to order one.
Patients are instructed to notify us if they have a new address or telephone number so that the company that manufactured the patient's pacemaker may contact the patient if needed.
Yes, patients can travel with your pacemaker and drive a car. Patients should be sure to always have the pacemaker identification card with them wherever they go.
At first, you may feel the weight of the pacemaker in your chest. However, over time, most people become accustomed to the pacemaker. The generator is very small, about the size of two silver dollars stacked on top of each other, and weighs about an ounce or less, depending on the make and model of the device.
Our Clinics
Our highly skilled electrophysiologists provide expert care for people with all types of arrhythmias. We are at the forefront of research, studying the most advanced devices and techniques for managing heart rate and rhythm.
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2nd Floor, Room A260
Stanford, CA 94305
Phone: 650-736-7878