What Are The Risks In Having A Pacemaker Placed?

— -- Question: What are the risks in having a pacemaker placed?

Answer :The insertion of a pacemaker is a common medical operation that we perform in patients that have slow heart rhythms or that have an electrical system in their heart that's unreliable. This keeps people's heart rhythms going fast enough so that they feel well or they do not get dizzy or pass out.

We usually insert these in the upper chest underneath the collarbone. This requires a small surgical incision to make a pocket for the pacemaking generator. And there's a pacemaking wire that is inserted into the big vein underneath your collarbone called the subclavian vein. And this is advanced inside the vein to the right side of your heart.

Depending on the type of pacemaker you get, you may get a single chamber pacemaker just pacing the bottom chamber of your heart, or a dual chamber pacemaker pacing both the top and bottom part of the hearts.

The risk of this is, of course, that this is a small operation and infections can occur. These are very uncommon and occur in less than one percent, but you will be treated with some antibiotics to minimize this. Your surgeon or cardiologist will be very careful not to introduce any adverse bugs. And you'll be instructed how to keep your pacemaker wound very clean.

The importance of this is that if you do get an infection with a generator and wire that is usually inert, this can create an infection which would not heal. This is the most devastating side effect of a pacemaker insertion.

Obviously, some other type of problems could be that you could have some bleeding from the pacemaker wound where one sticks the vein. Sometimes the lead can move or even poke a hole in the heart. These are very uncommon, and outside of an infection the thing we're most concerned about is the pacemaker lead moving. We usually screw these in, actually, into the heart muscle with a small little screwdriver at the end of the lead and that helps attach these leads to the heart.

But sometimes even with that, the leads will move. So you will be given instructions after your pacemaker on how much you can lift and how much you could use your arms.

The good news is that once this heals -- after a few weeks-- you can return to all normal activities and sports without any problems.