11 Things Doctors Want You to Know About Pacemakers

Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Marijke Vroomen Durning, RN on September 18, 2020
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    An Increasing Need for Pacemakers
    As the U.S. population ages, more people need pacemakers to keep their heart pumping as it should. That’s because the risk of heart-related problems increases with age. If your heart has periods when it beats too slowly or erratically, your cardiologist may refer you to a pacemaker doctor or specialist, known as an cardiac electrophysiologist. This doctor will determine if a pacemaker is the best treatment for you and perform the pacemaker procedure. Read what it’s like to get a pacemaker today, why they’re safer today than ever before, and pacemaker information cardiologists want their patients to know.
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    1. “A pacemaker insertion is a minor surgical procedure.”
    Implanting a pacemaker isn’t major heart surgery and recovery is usually fairly quick. “In most places, patients stay overnight [after the procedure], they get an X-ray in the morning, and then go home,” said Mark A. Goldstein, MD, a cardiologist at The Heart Center at Lutherville and The Heart Center at Reisterstown, in Maryland. Typically, doctors use a local anesthetic before making a small incision—usually under the collarbone—and inserting the pacemaker and leads. Most patients also receive a sedative intravenously (by IV) to help them relax.
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    2. “The pacemaker is always ‘on,’ but not always working.”
    When your heart rate is at an acceptable rate, the pacemaker is not actively doing anything. “If you have an abnormal rhythm, the pacemaker detects it and gives you a pace, or a mechanically induced beat,” said Luigi Di Biase, MD, PhD, section head of electrophysiology and director of Arrhythmia Services at Montefiore Einstein Center for Heart & Vascular Care in Bronx, N.Y. The pacemaker can work anywhere from 5% of the time to much more often, depending on the need. “The number of patients who need it 100% of the time are in the minority, so the pacemaker just sits there and whenever it’s needed, it intervenes.”
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    3. “You won’t feel the pacemaker when it does work.”
    “Under normal circumstances, you don’t even know the pacemaker is there,” said Goldstein. “You’re not going to feel anything different when the pacemaker is working.” However, you may be able to tell when it’s not working properly. “If your heart rate goes down below 60 beats per minute or the rate the pacemaker is set, it may be a sign there’s an issue with the pacemaker.” Pacemaker problems can occur, but they’re rare, he pointed out. Speak with your doctor if you start to feel lightheaded or dizzy, or you just don’t feel right.
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    4. “Pacemaker safety has evolved and improved.”
    “One of the most common misconceptions about pacemakers is the belief that you can’t stand close to a microwave oven if you have a pacemaker,” says Raul Weiss, MD, director of the Electrophysiology Fellowship Program and professor of internal medicine at The Ohio State University Wexner Medical Center. “It stems from very old pacemakers and very old, probably first-generation microwave ovens,” he said. Those microwaves were not shielded as the ones on the market today, so there was interference. “Today, you can be next to a microwave with zero problem,” Weiss said. The pacemaker will not be affected by any radiation or other “noise” from the oven.
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    5. “There’s no need to avoid cell phones either.”
    Some patients have told Di Biase they’ve heard they shouldn’t use a cell phone on the side of their pacemaker. This isn’t true, he said. Goldstein agrees. “Cell phones in general are not an issue these days,” he said. “The pacemakers are pretty protective against them.” It is recommended, however, that you don’t keep your cell phone close to your chest, such as in your breast pocket, for more than a few minutes. 
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    6. “A pacemaker does not limit your travels.”
    As long as you are healthy enough overall to travel, a pacemaker shouldn’t keep you at home. Going through security at the airport won’t stop your pacemaker from working or cause it to malfunction, but you may set off an alarm. “When you approach security, you have to tell them, ‘I have a pacemaker, I need a manual check,’” Weiss said. You can also show the agent your pacemaker ID card, which indicates the type of pacemaker you have, if needed. The agent should take care not to hold the manual wand close to your chest for more than a few seconds though.
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    7. “You may still have to take medication even if you have a pacemaker.”
    Pacemakers don’t cure heart disease, so depending on what causes your heart to beat too slowly, you may still have to take heart medicine once you have received your pacemaker. For example, if you take medications to lower your blood pressure or to eliminate excess fluid, you will probably still need them. Some heart medications actually slow down the heart but they’re still essential. If you need such a medication but there’s concern it will slow down your heart rate too much, you may be given a pacemaker. “Then, the pacemaker is needed in order to increase the amount of medication that the patient can receive,” Di Biase explained.
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    8. “You can live a normal life with a pacemaker.”
    “People with pacemakers live perfectly normal lives,” said Goldstein. Depending on your overall health, your pacemaker shouldn’t limit what you can do. “People with pacemakers can play sports; they can participate in most activities. It can help them improve their quality of life.” That said, some activities may be restricted, so check with your doctor if you plan on embarking on new physically challenging activities or any that could cause trauma or blows to the chest.
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    9. “Changing the battery is a simple procedure.”
    “A pacemaker’s battery is like your phone battery,” said Di Biase. “If you stay on the phone and talk all the time, the battery duration is lower than if you have a phone that is turned on but you don't answer it. If you are pacemaker dependent and it works all the time, the average duration is 5 to 6 years. If you need it once in a while, it should last 8 to 10 years.” If the wires are still good, which is usually the case, your doctor only has to remove the old pacemaker and connect a new one.
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    10. “Speak with your doctor about your pacemaker before any medical tests.”
    Medical test equipment, like pacemakers, is becoming more sophisticated. For example, while it used to be impossible for a patient with a pacemaker to have an MRI (magnetic resonance imaging) test, newer MRI machines can be used for people with newer model pacemakers. “If you get a pacemaker today or a defibrillator, which are also pacemakers [for delivering a shock to the heart], almost 100% of them are MRI compatible,” said Weiss. Other tests or procedures might still not be compatible, however; so if your doctor knows you have a pacemaker, the treatment plan can be adjusted accordingly.
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    11. “Pacemakers have a high success rate and low complication rate.”
    There are few pacemaker side effects, or complications, said Di Biase, but there is a high success rate. “When you need a pacemaker, you feel better after.” Aside from some pain or discomfort after the procedure as the insertion area heals, there are few complications. Ask your doctor what you should watch for, such as signs of infection, and in what situations you should call the office. You will likely stop feeling the pacemaker is there after a while as you get used to having it.
Pacemakers: 11 Things Cardiologists Want You to Know
  • Raul Weiss MD FACC - Healthgrades - 11 Things Doctors Want You to Know About Pacemakers
    Director of Electrophysiology Fellowship Program at The Ohio State University Wexner Medical Center in Columbus, Ohio.
  • Mark A. Goldstein, MD - Healthgrades - 11 Things Doctors Want You to Know About Pacemakers
    Cardiologist affiliated with The Heart Center at Lutherville and The Heart Center at Reisterstown in Maryland.
  • Luigi Di Biase, MD, PhD - Healthgrades - 11 Things Doctors Want You to Know About Pacemakers
    Electrophysiologist and director of Arrhythmia Services, Montefiore Einstein Center for Heart & Vascular Care, Bronx, N.Y.

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 18
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.