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  • How your heart works

    Your heart beats (pumps blood) because special cells in your heart (the sinus node, your heart's natural pacemaker) produce electrical impulses. The impulses cause your heart to contract and pump blood. Your sinus node causes those impulses to travel down to the muscle walls of your heart, causing your heart to contract.

    Why your doctor wants you to have a pacemaker

    Sometimes, there may be an interference in the way the impulse travels. When this occurs, there may be problems that change your heart rhythm. They include either:

    • a heart beat that is slow
    • an irregular rhythm
    • a complete block of your heart's electrical impulse

    The pacemaker will make your heart beat regularly and give the cells in your body adequate oxygen and nutrition.


    A pacemaker helps your heart beat regularly and give your body the oxygen it needs.

    Before the procedure

    • You may eat up to eight hours before your procedure.
      • Eat light meals, such as oatmeal or toast.
      • Avoid foods that are heavy or high in fat, such as meat or fried foods.
    • Do not use chewing tobacco six hours before your procedure.
    • You may have clear liquids up to two hours before your procedure.
      • Drink water, fruit juice without pulp, black coffee, tea, hard candies and gum.
      • Do not have milk, yogurt or alcohol.
    • You may take some of your regular medicines with small sips of water. If you have diabetes, remind your doctor of your diet, medicine or insulin needs.
    • The area below your collarbone will be shaved, if needed.
    • A nurse will start an intravenous (IV) line in your arm.
    • The doctor may order certain blood tests be taken.
    • You will be asked to sign a consent form.

    During the procedure

    • You will receive an antibiotic (medicine) through your IV.
    • The doctor will numb the site with medicine.
    • The doctor will make an incision just below your collarbone for the pacemaker. The pacemaker and leads are attached. The leads are then positioned inside your heart.
    • The doctor will test the pacemaker to see if it is working properly.
    • The doctor will close the incision and put a dressing over it. 

    After the procedure

    • A chest X-ray and EKG will be done.
    • You will have your blood pressure, pulse and heart rhythm checked often.
    • A shoulder immobilizer may be placed on your procedure arm for 24 hours.
    • You will be on bedrest, as ordered by your doctor.
    • You may eat after you no longer need bedrest.
    • You will be given an informational booklet and an identification card before you leave the hospital.

    Care after a pacemaker implant

    After visit summary

    This is general information. Please see your After Visit Summary given to you by your provider for how to take care of yourself after surgery.

    Your health care team will work with you to understand any challenges you have after your hospital stay. This will help your team work toward a plan to make sure you have the right care and support to help manage your health after you leave the hospital.

    Your surgery

    You had a pacemaker placed in your chest to help your heart beat at a normal rate.

    What to expect after your surgery

    • A bruise and or nickel-sized lump around the incision site is normal. It may take two to three weeks for the bruising to go away.
    • Your skin may be discolored.
    • You may have mild discomfort.
    • Carry your device identification card in your wallet at all times and notify other health care providers that you have a pacemaker.

    Before the surgery

    • Tell your health care provider if you:
      • are pregnant
      • have a shellfish allergy
      • have a latex allergy
      • have diabetes
      • take a blood-thinner medicine
    • Remove any jewelry or piercings.
    • Arrange to have someone drive you home. You will not be able to drive after the surgery.

    Pain relief

    Take any prescription or over-the-counter medicine as directed.


    • If you have an arm immobilizer, wear it as directed for the first 24 hours.
    • For your safety, you will need a responsible adult to drive you home and to stay with you for 24 hours.
    • For 24 hours:
      • Do not drive or use any machinery.
      • Do not make important decisions.
      • Do not drink alcohol.
    • You may take a shower 24 hours after the procedure. Use a mild soap.
    • For four weeks:
      • Do not reach or stretch your arm on your affected side.
      • Do not lift more than 10 pounds.
      • Do not take a tub bath, go swimming or use a hot tub.
    • Your health care provider will tell you when it’s OK for you to shower, drive, return to work, exercise and have sex.
    • Slowly return to your regular level of activity.
    • Rest as needed.
    • Avoid smoking.

    Incision care

    • Keep the wound site clean and dry for the first 24 hours.
    • Apply pressure slightly above wound site if you laugh, cough or sneeze for 24 hours.
    • If your incision site is covered with Aquacel® dressing:
      • You do not need to cover it.
      • Gently pat dry the dressing site after you take a shower or bathe. Do not rub or scrub the site.
      • Do not remove the dressing. It will be removed at your wound check appointment.
    • Follow any directions your health care provider gives you.

    Food and beverages

    • Eat well-balanced meals. Follow any instructions your health care provider gave you.
    • Avoid alcohol while you are taking prescription pain medicine.

    When to call your health care provider

    Call your health care provider if:

    • you have a temperature of 101 F or higher
    • you have new pain or pain you can't control
    • you feel you are getting worse
    • you have new or worsening shortness of breath or occurring when lying flat
    • you have a weight gain of three pounds in one day
    • you have a weight gain of five pounds in one week
    • you feel a tightening, pressure, squeezing or aching in your chest or arms
    • you feel chest discomfort with pacing
    • your heart rate is less than 50 beats per minute
    • your breathing rate is more than 30 breaths per minute
    • you have signs of infection at your incision site:
      • pain
      • swelling
      • redness
      • odor
      • warmth
      • green or yellow discharge
    • you are unable to get out of bed
    • you have nausea (upset stomach), bloating or vomiting (throwing up) that won't stop
    • you have any questions or concerns.

    Call 911 if you feel you are having a medical emergency.

    Follow-up appointment

    Please keep all follow-up appointments with your health care provider or specialist, even if you are feeling well.

  • Source: Allina Health's Patient Education Department, Permanent Pacemaker Insertion, cvs-ah-31235 (last reviewed 4/15) and Care after a Pacemaker Implant, cvs-ah-10024 (last reviewed 8/16)
    Reviewed by: Allina Health's Patient Education Department
    First published: 10/04/2002
    Last reviewed: 08/01/2016