What to Expect
Pacemaker and Defibrillator Implantation
What are pacemakers and defibrillators?
A pacemaker is a small device that helps the heart beat at a regular rhythm and rate.
A defibrillator is similar to a pacemaker, but it sends electrical shocks to the heart if the heart stops beating.
When do we arrive for the appointment?
During the week before the procedure, you will receive a letter in the mail that gives the details about the time you are supposed to arrive at the hospital.
Most patients will come to the Surgery Center on level 6 of the hospital to check in.
What happens before the procedure?
After you arrive, a nurse will ask general health questions and your child will have a brief physical exam that includes weight and height measurements.
Your child's electrophysiologist will meet you to see if there have been any recent changes and to answer any further questions that you might have.
You will also meet the pediatric anesthesiologist who will be administering anesthesia during the case. The anesthesiologist may start an IV line (a tiny plastic tube that is placed in a vein) and also give some medications to help your child relax.
You will be given a pager so you can be paged with updates during the surgery and be notified when the procedure is complete.
What happens during the procedure?
The anesthesiologist will give your child medications to get her to sleep and keep her from feeling any pain during the procedure.
The cardiologist then makes a small incision, about two inches long, just below the collarbone for the pacemaker or defibrillator.
The doctor then threads one or two small leads (small flexible wires) through the veins of the chest into the heart, using X-ray to guide the placement. The leads are attached to the pacemaker or defibrillator and the incision is closed.
For patients who are receiving a defibrillator, the doctors will also test the device to make sure that it will work when needed. To do this, the doctor puts the patient's heart into the abnormal rhythm while closely monitoring him. The device detects the arrhythmia and restores the heart to its normal rhythm.
Your child will receive antibiotics before and after the procedure. The cardiologist will recheck the device to make sure that it is working well, and then cover everything with a sterile dressing.
During the procedure, having a pager with you means you can wait anywhere in the hospital that is comfortable for you. A nice place to wait is the Family Resource Center on level 7 in the River zone.
How long does the procedure take?
Inserting a pacemaker or defibrillator takes about three hours. If the cardiologist only has to change the generator battery, the procedure may only take one to two hours.
What happens after the procedure?
After the procedure is completed, your child will wake up in the recovery room, where he will stay for an hour.
Nurses will monitor your child to make sure that she is awake enough to eat and drink. The doctor will check an X-ray to make sure that everything is in place.
When can my child go home?
If your child is getting a new pacemaker or defibrillator, he will spend the night and go home the next day. He will get antibiotics overnight, and pain medicine if he is uncomfortable. The following morning the doctors will check another X-ray.
Prior to discharge, a nurse will review with you what signs to look out for after procedure, safe ways to hold and lift your child, medicines to give and how to help your child slowly increase his activity.
If the doctors are only changing the generator battery, your child will likely go home the same day.