What precautions should be taken after a pacemaker is installed?

A pacemaker is an electronic therapeutic device implanted in the body. It emits electrical pulses powered by a battery through a pulse generator. The electrical pulses are conducted through wire electrodes to stimulate the myocardium that the electrodes contact, causing the heart to become excited and contracted, thereby achieving the purpose of treating heart dysfunction caused by certain arrhythmias.

That is to say, when the heart has irreversible pathological changes due to some reasons, the pacemaker may be the most effective and almost the best way. For example, when the heart has a high degree of atrioventricular block and sinus node dysfunction, the pacemaker is the most effective method.

However, you should never think that everything will be fine after a pacemaker is installed and you can continue to squander your health. There are many things to pay attention to after a pacemaker is installed. And there are probably more things to pay attention to. If you don't make fundamental changes, the pacemaker may not be able to bear the weight of life.

Below, we will explain to you from a professional perspective the precautions after installing a pacemaker:

1. Do not do strenuous activities after surgery to prevent electrode dislocation. During hospitalization, you must consult medical staff about body position, activity methods, and even lying position;

2. Keep your emotions stable, happy, and optimistic. A heart that already has problems cannot withstand high excitement or agitation, and high-intensity exercise is even more undesirable.

3. The patient should learn to count his or her own pulse. If the pulse rate is inconsistent with the set frequency (slow), it may be that the pacemaker battery is insufficient. The patient should contact the attending physician in time for replacement;

4. Does the heart rate remain unchanged after the pacemaker is installed? This mainly depends on the type of pacemaker installed. For example, if a pacing-dependent patient with sick sinus syndrome is equipped with a single-chamber pacemaker, the heart rate will remain unchanged. The heart will beat as many times as the machine is adjusted. If it is too fast or too slow, it is not right. You should contact the attending physician in time for a diagnosis.

5. Excluding other factors, if some new symptoms appear, such as chest tightness, headache, edema, fatigue, etc., you should consider that there is a maladaptive condition, called pacemaker syndrome, and you can contact the attending physician to discuss the treatment plan;

6. If the symptoms before the implantation occur after the pacemaker is implanted, such as fainting, breathlessness, or inability to walk, it is a malfunction of the pacemaker and you should seek medical attention immediately;

7. When seeking medical treatment for other issues, you should inform the doctor that you have an artificial cardiac pacemaker, such as undergoing an MRI or other examinations and treatments that may affect the function of the pacemaker;

8. In daily life, do not massage or touch the pacemaker implant site at will, keep the skin clean and dry, reduce friction, and check the site for redness, swelling, heat, pain, and other inflammatory reactions or bleeding. If you feel any discomfort, seek medical attention immediately;

9. Avoid strenuous exercise. For the upper limb with a pacemaker, avoid doing excessive or large movements (such as carrying heavy objects, playing tennis, using heavy tools, etc.) to avoid affecting the pacemaker function or causing the electrode to fall off.

10. Patients should avoid entering and leaving places with high electricity (high voltage electric field) and strong magnetic field, and stay away from certain household appliances with strong radiation or interference and hospital physical therapy equipment to avoid affecting the pacing function or causing damage to the pacemaker;

11. Patients should carry and properly preserve the pacemaker implantation card (with pacemaker model, relevant parameters, installation date, etc.) or a card that can clearly express the pacemaker information so that the attending physician can obtain the pacemaker information when seeing the patient. In addition, it is also convenient for passing the metal detector inspection when boarding the aircraft;

12. Regular follow-up is performed to measure pacemaker function. Professional physicians can accurately assess the working status of the pacemaker and the condition of the battery.

In short, having a pacemaker installed is not the end of the world. Health is your own business. A pacemaker can only ensure that the heart can still pace, but it cannot guarantee that there will be no problems in other parts of the body. If you continue to squander your body or ignore your health, the pacemaker will be powerless. For the health of your family or friends who have pacemakers installed, please quickly pass on this knowledge to them!

Wu Xiaoyuan, Department of Internal Medicine, Guangdong First Veterans Hospital

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