What is leadless pacemaker placement?

A leadless pacemaker is a small, battery-powered device. It sends mild electrical signals to your heart to keep it beating normally. These signals are painless. The pacemaker can help stop the dizziness, fainting, and shortness of breath caused by a slow heart rate.

You will get medicine before the procedure. It helps you relax and helps prevent pain.

Your doctor doesn't need to make any cuts to do the procedure. Instead, your doctor uses a thin tube called a catheter. The pacemaker is placed inside the catheter. The doctor puts the catheter into a blood vessel in your groin. You will get a shot to numb the skin where the catheter goes in.

Then the doctor moves the catheter through the blood vessel to your heart. You may feel pressure when the doctor does this. Your doctor may also have injected a dye into your blood vessel and heart. The dye shows up on a screen. It helps your doctor see where to move the catheter and pacemaker.

When the catheter is inside the lower right chamber of the heart (right ventricle), the doctor moves the pacemaker out of the catheter. Your doctor attaches the pacemaker to the heart tissue so that it doesn't move. Flexible hooks may be used. Then the catheter is removed from your body.

You may spend the night in the hospital, or you may go home the same day. Your groin may have a bruise and feel sore for a few days.

If you are worried about having a pacemaker, it may help if you learn about how the pacemaker helps your heart. Talk to your doctor if you have concerns.

Activity

• If the doctor gave you a sedative:
  • For 24 hours, don't do anything that requires attention to detail, such as going to work, making important decisions, or signing any legal documents. It takes time for the medicine's effects to completely wear off.
  • For your safety, do not drive or operate any machinery that could be dangerous. Wait until the medicine wears off and you can think clearly and react easily.
• Do not do strenuous exercise and do not lift, pull, or push anything heavy until your doctor says it is okay. This may be for several days. You can walk around the house and do light activity, such as cooking.
• Try not to walk up stairs for the first couple of days.

Diet

• If you had dye injected, drink plenty of fluids to help your body flush out the dye. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Call your doctor if you think you are having a problem with your medicine.

Care of the catheter site

• For 1 or 2 days, keep a bandage over the spot where the catheter was inserted. The bandage probably will fall off in this time.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Put a thin cloth between the ice and your skin.
• You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
• Do not soak the catheter site until it is healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
• Watch for bleeding from the site. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
• If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or seek immediate medical care.

Other instructions

• Keep a medical ID card with you at all times that says you have a pacemaker. The card should include the manufacturer and model information.
• Wear medical alert jewelry stating that you have a pacemaker. You can buy this at most drugstores.
• Tell all of your doctors, dentists, and other health professionals that you have a pacemaker before you have any test, procedure, or surgery.
• Ask your doctor for a list of electric devices that you might need to keep a short distance from your pacemaker.
• Check your pulse as directed by your doctor.
• Have your pacemaker checked as often as your doctor recommends. In some cases, this may be done from your home. Your doctor will give you instructions about how to do this.

The procedure usually takes 30 to 40 minutes.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

A leadless pacemaker is a small, battery-powered device. It sends mild, painless electrical signals to your heart. This keeps it beating normally. Your doctor used a catheter to place the pacemaker inside your heart.

Your groin may have a bruise and feel sore for a few days. You can do light activities around the house. But don't do anything strenuous for several days.

You'll need to take steps to safely use electric devices. Some of these devices can stop your pacemaker from working right for a short time. Check with your doctor about what to avoid and what to keep a short distance away from your pacemaker. For example, you will need to stay away from things with strong magnetic and electrical fields. An example is an electronic body fat scale. You can use a cell phone and other wireless devices, but keep them at least 6 inches away from your chest. Many household and office electronics don't affect a pacemaker.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
• After the procedure, pressure may be applied to the area where the catheter was put into your blood vessel. This will help prevent bleeding. A small device may also be used to close the blood vessel. The area may be covered with a bandage or a compression device.
• Nurses will check your heart rate and blood pressure. The nurse also will check the catheter site for bleeding.
• You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.
• You will need to lie still and keep your leg straight for up to a few hours. The nurse may put a weighted bag on your leg to keep it still.
• The procedure will take about 30 to 40 minutes.

Your doctor doesn't need to make any cuts to put the pacemaker in your heart. Instead, a thin tube called a catheter is used. The doctor threads the catheter through a blood vessel into the heart. The doctor then removes the pacemaker from the catheter and attaches it to the heart tissue.