Pacemaker A Guide for Patients and Families

Transcription

1 1 Pacemaker A Guide fr Patients and Families What is a pacemaker? A pacemaker is a small electrnic device that helps yur heart beat at the right rate. When needed, it sends an electrical impulse t yur heart, triggering a heartbeat. A pacemaker has tw parts: a generatr and pacing leads. 1. The generatr is a small cmputer that mnitrs yur heart beat. When needed, it sends an electrical impulse thrugh the pacing lead t yur heart, triggering a heartbeat. It is pwered by a specially designed battery. 2. The pacing leads (yu may have 1 r mre) are insulated wires. One end cnnects t the generatr. The ther end attaches t the inside f yur heart. An electrical impulse frm the generatr travels dwn the lead t make the heart beat. Pacemaker Generatr What s inside? Why d I need a pacemaker?... 2 Are there any risks?... 2 What can I expect befre and after?... 3 When shuld I get help?... 5 Living with a pacemaker... 5 Frequently asked questins... 8 Helpful resurces..10 Pacing Leads 1

2 Why d I need a pacemaker? Yur heart has an electrical system made up f special cells. It signals yur heart muscle t squeeze r cntract t pump bld and xygen t yur bdy. Smetimes this system is damaged by aging r heart disease. This can result in: A slwer than nrmal heart rate (bradycardia) Lng pauses between beats (heart blck) Switching between slw heart beats (bradycardia) and fast heart beats (tachycardia) If yur electrical system is nt wrking well, it can cause yu t feel tired, dizzy, faint, r shrt f breath. The pacemaker helps keep yur heart beating prperly. Are there any risks? The prcedure t insert a pacemaker is called implantatin. A pacemaker implant is cnsidered a rutine, minr surgical prcedure with little chance r risk f prblems. Bruising arund the implant site is cmmn. Hwever, as with any medical prcedure, prblems are pssible. Althugh rare, these prblems are imprtant t knw (listed here frm mst likely t least likely): Prblem Chance f it happening Hw it is treated Pacing lead becmes disldged Bleeding arund the pacemaker site (hematma) Cllapsed lung (pneumthrax) Infectin Cllectin f bld arund the heart (cardiac tampnade) 2 t 4% chance (20 t 40 peple in 1000) 1 t 2 % chance (10 t 20 peple in 1000) 1 t 2 % chance 1 t 2 % chance 0.1 % (1 persn in 1000) Anther prcedure wuld be needed t put the lead back int psitin. Smetimes the bleeding arund the pacemaker is large enugh that the bld needs t be drained ff. Chest x-ray is dne after the prcedure t check fr this. Often, it des nt need t be treated, but it might need a drain int the chest t help the lung return t nrmal. T prevent an infectin, everyne is given antibitics befre the prcedure. They may be required after the prcedure is an infectin ccurs Often, it des nt need t be treated, but it might need t be drained. It is imprtant t ask yur dctr abut the risks f a pacemaker implant in yur specific situatin. 2

3 What can I expect befre and after? Hw t prepare fr the prcedure Always bring yur BC Services Card (r Care Card) plus a list f the medicatins yu are currently taking t every appintment and the day f yur prcedure. Yu will nt be allwed t drive fr at least 1 week fllwing the pacemaker implant. Since yu cannt drive hme after yur prcedure, arrange fr smene t drive yu t the hspital and hme again. Yu als need t arrange fr smene t stay with yu at hme fr the first 24 hurs after the prcedure. Yu will get mre specific instructins frm the hspital r ffice f the dctr ding the prcedure. Yu will be instructed as t hw t take yur medicatins befre the prcedure. Certain medicatins (like bld thinners and diabetic pills) might need be adjusted. It is imprtant t review these instructins carefully and take medicatins as directed. A week r s befre the prcedure, yu might be asked t g fr sme bld wrk and an electrcardigram (E.C.G.). D nt eat r drink anything the mrning f yur prcedure, unless yu have been specifically tld smething different by the hspital r yur dctr. Befre the prcedure Yu are admitted and directed t the prcedure waiting area. If yu are already a patient in hspital, yur healthcare team will help yu get ready fr the prcedure. A nurse starts an intravenus (I.V.) in ne f yur arms t give yu medicines during the prcedure. Yu have bldwrk drawn and an electrcardigram (ECG). The dctr reviews the prcedure and then yu will be asked t sign a cnsent frm. 3

4 During the prcedure Mst peple are awake fr the prcedure. Yu are given a medicine t help yu relax and feel cmfrtable. The dctr injects numbing medicine under the skin t freeze the area where the pacemaker is being implanted. A small cut r incisin is made n the right r left side f the upper chest just belw yur cllarbne. Yur dctr talks with yu befrehand abut which side is best fr yu. The dctr uses a special x-ray t guide the pacing lead(s) thrugh a large vein and int yur heart. Once the leads are attached (implanted) in the inside f the heart, they are tested t make sure they are wrking crrectly. The pacemaker generatr is then placed in a space under the skin. The incisin is clsed with stitches that disslve n their wn ver time. The prcedure takes abut 1 hur. After the prcedure Yu are mved t a recvery area. The nurses there mnitr yur heart rhythm and bld pressure. Yu might feel sme discmfrt arund the incisin and yu might have a sre shulder. Let the nurses knw if yu are having any pain s they can give yu medicine t relieve it. The nurses let yu knw when it is safe fr yu t eat and drink. Yu might g hme frm this area r yu might be mved t anther unit if yu need t stay in the hspital lnger. Ging Hme Hw sn yu g hme depends n yur medical cnditin and recvery frm the prcedure. Mst peple g hme the same day. Sme peple need t stay in the hspital fr a few days. 4

5 Befre yu leave hspital, yu are given instructins n hw t care fr yurself at hme. The nurse reviews this infrmatin with yu and it includes : Caring fr yurself at hme Driving restrictins Caring fr yur incisin Restrictins t arm mvements Managing pain Pacemaker clinic fllw-up appintments When t take medicatins When t get help Nte: The persn staying with yu fr the first 24 hurs shuld be there t hear these instructins. When t get help Cntact yur family dctr right away if yu ntice any f the fllwing: Any redness, swelling, r clured liquid cming frm yur incisin A fever ver 38.0 C (100.4 F) New bruising r redness arund the incisin Pain that gets wrse r des nt imprve with pain medicine Shrtness f breath Chest pain Cntact yur pacemaker clinic right away if yu ntice any f the fllwing: Feel faint Feel dizzy Heart skipping beats (palpitatins) Call r have smene take yu t the nearest emergency rm if yu d nt feel well r yu feel wrse frm any f these abve cncerns. (D nt drive until yu have been checked). Living with a pacemaker Peple wh receive a pacemaker can return t their nrmal activities f daily living. Belw are tips t help yu stay healthy. Attend fllw-up appintments Every persn with a pacemaker needs t be checked regularly by a pacemaker clinic. This culd be a mix f in-persn clinic visits and remte mnitring frm hme. 5

6 Remte mnitring is a way fr yur pacemaker t send infrmatin abut yur heart activity wirelessly frm hme. Yur infrmatin is sent thrugh a secure cnnectin t a secure website. If this is an ptin fr yu, the pacemaker clinic team will yu help yu t get started. Befre yu leave the hspital, speak t yur nurse r dctr abut the pacemaker clinic clsest t yur hme. Yur first appintment will be within 2 mnths. After this, yur pacemaker must be checked by the clinic at least nce every year. Let yur clinic knw f any changes in yur address r phne number. During visits t the clinic, the clinic team: Check yur pacemaker battery and leads. Review yur settings t make sure it is prgrammed t best meet yur needs. Adjust the pacemaker settings as needed. Prtect yur pacing leads The mvement f yur arm n the same side as yur pacemaker may be limited fr a perid f time after the prcedure. The instructins frm the hspital will include what yu can and cannt d. Fr at least 6 weeks after the prcedure, yu are nt allwed t d any strenuus shulder activities like glfing, swimming, tennis, shvelling, raking, r vacuuming. These restrictins prevent the pacing leads frm being disldged. Prtect yur pacemaker generatr D nt place magnets near yur pacemaker. Keep magnets at least 6 inches frm the generatr. Never put a cell phne in a pcket ver yur pacemaker. Walk thrugh anti-theft detectrs at a nrmal pace withut any delay. D nt remain in r near the system fr any length f time. They have electrmagnetic fields and can temprarily affect yur pacemaker. Keep the generatr away frm these items: At least 6 inches (15 cm) away - hand held electric kitchen appliances (e.g. mixers and knives), electric tthbrush charging bases, electric shavers, exercise bikes and treadmills, hand held hair dryers, stere speakers, vacuums, sewing machines, and radi-cntrlled items (including the antenna). 6

7 At least 12 inches r 1 ft (30 cm) away - electric fences, vehicle ignitin systems, green electrical transfrmer bxes fund utside, car battery chargers, generatrs 20 kw r less, uninterrupted pwer surces (UPS), and gasline pwered tls (e.g. chainsaws, lawn mwers, weed trimmers, and snw blwers). At least 24 inches r 2 feet (60 cm) away - inductin ck tps, jumper cables, bench munted r free-standing pwer tls with 400hp mtrs r less (e.g. air cmpressrs, drill presses, grinders, pressure washers, table saws, and welding equipment with currents under 160 amps). D nt use: TENS machines, magnetic mattresses r pillws, muscle stimulatrs. Stay away frm large magnets such as the nes fund n cranes r in junkyards t lift cars. If yu wrk in any high vltage areas, talk t yur dctr r pacemaker clinic. High vltage is fund arund things like arc welders, smelting furnaces, radi and televisin twers, and hydr and radi statins. Tell thers yu have a pacemaker At the hspital, yu are given a temprary pacemaker identificatin card describing what type f pacemaker yu have. Always carry this ID with yu. The cmpany that made yur pacemaker will mail yu a permanent Pacemaker Identificatin card abut 4 t 8 weeks after yur prcedure. Always tell yur dentist, physitherapist, massage therapist, and chirpractr yu have a pacemaker. They might need t take special precautins befre starting certain medical prcedures r therapies. Take yur medicatins Make a list yur medicatins, the dsage, and the times yu take them. Always bring this list t all yur pacemaker fllw-up appintments. Remember t update yur list when they change Take them exactly as instructed. Stay active Mst peple return t their usual daily activities, nce they have recvered. Include physical and mental activity int yur daily schedule. Each persn is unique. Talk t yur dctr abut the kind f activities and exercises that are best fr yu. Start slwly and gradually increase. 7

8 Fr mst peple, it is safe t resume sexual activity after a pacemaker implant, hwever try nt t supprt yur weight with yur arms during sexual activity while yur incisin is healing. Ask questins Call yur heart dctr r family dctr. Call yur Pacemaker Clinic. Call HealthLink BC at any time f the day r night t speak t a registered nurse. During the night, yu can ask t speak t a pharmacist. Pacemaker cmpanies ffer nline supprt fr nn-urgent questins r cncerns. Their cntact infrmatin is available nline r in yur pacemaker infrmatin bklet. Frequently Asked Questins When can I drive? Fr yur wn safety and the safety f thers, yu must fllw the mandatry driving restrictins in the British Clumbia Mtr Vehicle Act. The Act says that after a pacemaker implant: Yu are nt allwed t drive a private vehicle fr 1 week after the prcedure (class 5 license). Yu are nt allwed t drive a cmmercial vehicle fr 1 mnth after the prcedure (class 1 t 4 license). What is electrmagnetic interference (EMI)? Any items that generate, transmit, r use electricity have invisible electrmagnetic fields arund them. This electrmagnetic field might affect the nrmal peratin f yur pacemaker. This is called electrmagnetic interference (EMI). Mst husehld items are safe t be near and use, including items such as: battery chargers, curling irns, hair straighteners, electric blankets, guitars r tthbrushes, massage chairs, heating pads, ht tubs, saunas, tanning beds, electrnic weight scales, and kitchen appliances including micrwave vens. It is als safe t be near and use electrnics such as TV s, radis, cmputers, tablets, MP3 players, fax machines, phtcpiers, DVD and CD players with remte cntrl, printers, and GPS devices. 8

9 What d I d if I think an item is causing EMI? If yu feel dizzy using an electrical item, put it dwn and mve away frm it. Yur pacemaker shuld return t nrmal. If yu cntinue t feel dizzy r feel wrse, cntact yur pacemaker clinic r dctr right away. Can I travel with a pacemaker? It is safe t travel with a pacemaker. Let the pacemaker clinic knw if yu are planning t travel. Ask hw t get help medical help if needed and hw t set up yur remte transmitter while yu are away. It is safe t pass thrugh the airprt metal detectr, have a bdy scan and use a hand-held metal detectr. If the detectr alarms tell airprt security persnnel yu have a pacemaker and shw them yur Pacemaker ID card Hw lng will my pacemaker last? The pacemaker battery will need replacing ver time. This minr prcedure is called a generatr (battery) change. Yur pacemaker clinic will rganize a replacement when needed. The battery generally lasts 8 t 10 years but will depend n hw much yur bdy needs the pacemaker t pace yur heart. If yur pacing leads are wrking well, they are left in place. Pacemakers d nt stp withut warning. Even as the battery weakens, yur pacemaker cntinues t wrk as it shuld. What happens t my pacemaker at end f life? Pacemakers d nt keep dying peple alive. Shuld yur health decline t the pint where death is likely, yur pacemaker will nt prevent a natural death. 9

10 Fr Mre Infrmatin This bklet explains basic infrmatin abut living with a pacemaker. Fr mre detailed infrmatin abut getting a pacemaker, read the infrmatin given t yu by yur dctr s ffice r hspital befre the prcedure. Fr mre detailed infrmatin abut yur specific pacemaker, read the bklet frm the cmpany that made the pacemaker, r visit their website. If yu have questins that are nt addressed in this bklet, ask yur dctr r clinic. Helpful Resurces Heart and Strke Fundatin f Canada Canadian Heart Rhythm Sciety Chse Pacemakers frm the Main Menu under Heart Rhythm Health Resurces r use this link: g.gl/g4ttvl Heart Rhythm Sciety HealthLinkBC Phne: Chse Patient Resurces Phne: fr deaf r hard f hearing Device Cmpany Medtrnic Abbtt / St. Jude Medical Bstn Scientific Website Reasn Phne ENGLISH FRENCH Bitrnik N/A Srin N/A Questins abut yur device: Questins n trubleshting Carelink: Questins abut yur device and Merlin: Questins abut yur device and LATITUDE:

11 February 2018