Permanent pacemaker is an electronic device that is generally implanted into the subcutaneous muscle tissue. When the heart beat is too slow and produces discomfort, or there are other special therapies required, the permanent pacemaker will transmit electronic impulse to the heart and stimulate heart contraction.

Which people need to install permanent pacemakers?

• Third degree complete atrioventricular block (AVB)
• Second degree AVB with symptoms.
• Sick sinus syndrome
• Carotid sinus syndrome.
• Other special conditions that are evaluated by the physicians for need to install permanent pacemakers and will help improve the condition of disease.  For examples, hypertrophic cardiomyopathy (HOCM) with syndromes that could not be cured by medicine.

Pre-installation Preparation

• Fill out the letter of agreement.
• Clean the upper body with soap on the night before and in the morning that day, before the installation.
• Implement fasting in 4~6 hours before installation or the nurses will inform the time for fasting.
• Change surgical gown and wait for notice from the examination unit.

Post-installation precautions

• Drink water after returning to the room and start eating if not experiencing any discomfort.
• In case of experiencing any discomfort such as fever, excessively fast or slow heartbeats, dizziness, breathing difficulty, chest tightness, swelling, inflamed and painful wound, inform the medical staff immediately.
• In 48 hours after installation, the patient may engage in joint exercise on the side of the limbs. However do not lift the limbs abruptly.
• The physician will apply antibiotics after the installation to avoid infection. The nurses will assist the patient with dressing change daily. Keep the wound dry and avoid water contact.
• Move slowly in 2 months after the installation. Do not lift heavy articles to prevent pacemaker relocation.
• Please follow physician prescription for medication. Do not administer any medicine without prescription.

Daily precautions for patients installed with pacemakers

• Regular life and normal routines.
• Except for the medicines prescribed by physicians, do not take any medicine without prescription.
• Patients may restore daily activities such as bathing, working, and driving. However do not buttstock with the arm on the side of installation during target practice.
• Take pulse for 1 minute and record it at fixed time every day.
• Wear loose cloths and avoid exerting pressure to the wound.
• Keep the wound dry without impact or playing with the pacemaker. Check for any swelling, inflamed pain, secretion, bleeding, or exposure daily. Return to the hospital for examination immediately in case of experiencing any of the foregoing symptoms.
• Avoid accessing venue with high voltage and strong magnetic wave such as MRI examination room, voltage conversion station, and television, broadcasting, or radar transmission station.
• The average home appliances will not affect the pacemakers. However avoid using home appliance with poor quality (susceptible to power leak).  Contact with the physician for any questions.
• Do not lift heavy articles (greater than 5KG) in 2 months or after the surgery or quickly engage in fast activities with the shoulder such as badminton and tennis.
• Answering the mobile phones in at least 30cm from the pacemakers. Use another side of ear; when the mobile phones are on standby mode, do not place them on the front pocket to avoid affecting the pacemakers.
• Carry identity for pacemakers and notify the physicians of such installation of pacemakers upon the visit.
• Present the pacemaker identity when accessing the security checkpoint at the airport to avoid alarm and misunderstanding. Ask security check person to check with other means.
• The average life cycle of pacemakers is 7~10 years, which may vary according to the speed of patient’s heartbeat and power consumption, and hence requiring routine return visits.
• Please take the number of pulses and seek for medical help in case of the following conditions:

1. Breathing difficulties
2. Syncope
3. Chest pain
4. Continuous hiccup
5. Fatigue
6. Body fluid accumulation
7. Pulse rate taken is 5 times slower than the rate set up in the pacemaker.
8. Signs of infection: red, swelling and fluid on implanting area.