Leadless Pacemaker Placement: Before Your Procedure

Catheter moves through blood vessel from groin to heart's right ventricle, with detail of right ventricle

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.

How do you prepare for the procedure?

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.

What happens on the day of the procedure?

  • 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.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.