Pacemaker. Cardiomyopathy. This is when the heart has swollen up and cannot work properly.

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1 Pacemaker GENERAL INFORMATION: What is it? A pacemaker is a small device that helps regulate your heart rate. A pacemaker is about the size of a wristwatch. When your heart beats too slow and makes you feel dizzy your caregiver may want you to have a pacemaker. The pacemaker will make your heart beat at a faster rate so that you no longer feel dizzy. A pacemaker is made up of leads (thin flexible wires) and a generator (battery). Getting a pacemaker involves having a procedure done. Most pacemakers work only when they are needed. These are called demand pacemakers. Other pacemakers work all the time. Your caregiver will decide which pacemaker is right for you. Why do I need a pacemaker? Cardiomyopathy. This is when the heart has swollen up and cannot work properly. Dizziness, severe fatigue (tiredness), fainting (passing out), or confusion. Heart surgery. Slow heart rate. What kinds of pacemakers are there?pacemakers work when they need to or all of the time. There are 3 different kinds of pacemakers: Permanent: A permanent pacemaker is also called a long-term pacemaker. An incision (cut) is made in your neck or chest. The leads are guided through a vein into your heart, and attached to the generator. The generator is placed in a pocket under your skin. You will have this type of pacemaker forever. 12:15:39 PM]

2 Transcutaneous: This pacemaker is also called an external pacemaker. It is used in emergency situations when your heart is beating too slowly. When this happens, your caregiver needs to speed up your heart rate quickly. Small sticky patches are applied to your chest, and leads are attached to these patches. At the end of the leads is a pacemaker with dials on it. These dials allow your caregiver to immediately adjust the settings of the pacemaker. This type of pacemaker is used for a short time. After a time, you may need to get a permanent pacemaker, or you may not need a pacemaker anymore. Trasvenous: A transvenous pacemaker is also called a temporary pacemaker. The leads for the pacemaker are guided into your heart through an incision in your neck or chest. With a transvenous pacemaker, the generator is worn outside your body in a small pouch. You will carry this pouch with you everywhere. Your caregiver will decide which pacemaker is right for you. How do I get a pacemaker? You will need a procedure to get a pacemaker unless you have a transcutaneous pacemaker. The procedure will take about 1 to 2 hours. The procedure may be done while you are already a patient in the hospital. You may also come into the hospital in the morning and go home after your procedure. Your caregiver will make this decision. In some cases, you or your caregiver may want you to be completely asleep during the procedure. In most cases, you will be awake, but very drowsy. An anesthesiologist is a caregiver that gives medicine to make you sleepy and comfortable during your procedure. Your caregiver will give you intravenous medicine to help you relax. An incision will be made in your neck or chest. With the help of a special x-ray, the leads of the pacemaker will be guided into your heart. The leads may also be hooked to the outside of your heart. A pocket is made under your skin, usually just below your collarbone. This pocket is where the generator is placed. The leads are connected to the generator, and the pacemaker is programmed especially for the needs of your heart. What does it feel like?once the pacemaker is in you, you will not feel it watching your heart. You will be able to see and feel the outline of the pacemaker through your skin. Coping:You and your family may feel scared, confused, and anxious after the pacemaker procedure. You may be afraid that the pacemaker will not work. These feelings are common. Talk about them with your caregiver or with someone close to you. For more information, you may call or write: American Heart Association 7272 Greenville Avenue Dallas, TX Phone: Web Address: CARE AGREEMENT: You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 12:15:39 PM]

3 Thomson Reuters. All rights reserved. 12:15:39 PM]

4 Pacemaker WHAT YOU SHOULD KNOW: A pacemaker is a small device that helps regulate your heart rate. A pacemaker is about the size of a wristwatch. When your heart beats too slow causing dizziness, your caregiver may want you to have a pacemaker. The pacemaker will make your heart beat at a faster rate so that you no longer feel dizzy. A pacemaker is made up of leads (thin, flexible wires) and a generator. Most pacemakers work only when they are needed. These are called demand pacemakers. Other pacemakers work all the time. Your caregiver will decide which pacemaker is right for you. You will need a procedure to get a pacemaker unless you have a transcutaneous pacemaker. This procedure may be done while you are already a patient in the hospital. You may also come into the hospital in the morning and go home after your procedure. You may also need to stay in the hospital for a time. AFTER YOU LEAVE: Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Activity Guidelines: Ask your caregiver if you need to avoid moving your shoulder or arm, and for how long. Ask your caregiver if you should avoid lifting heavy objects.

5 You may not be able to play contact sports such as football and wrestling because these could damage your pacemaker. Do not play other sports such as tennis, golf, or basketball until your caregiver tells you it is okay. Do not rub the area over the pacemaker until your caregiver says it is okay. Ask your caregiver when you can return to work. Ask your caregiver when you can start driving again. Do not shower or bathe until your caregiver says it is okay. Do not put any lotion or powder on the incision area. What special things should I do after I have my pacemaker? Carry the ID card that your caregiver has given you. This card provides information about the type of pacemaker and leads you have. Keep emergency numbers within easy reach. Stay away from large magnets. This includes a MRI test (a MRI uses powerful magnets). It is safe to use major household appliances. These include microwaves, computers, toasters, hairdryers, and heating pads. You can safely pass through security at airports. Be sure to have your pacemaker ID card with you. Avoid leaning into a car engine or doing welding. You may need to change your job if you do these things for a living. You can use cellular phones. Be sure to hold the cellular phone on the opposite ear of where the pacemaker is located. Do not carry your cellular phone in a shirt pocket near the pacemaker. Ask your caregiver when you can use ice after surgery. Wrap the ice in a towel and then place the towel over the pacemaker site. Never apply ice directly to your skin. Ask your caregiver how often and how long to place ice on your pacemaker site. Let your dentist know that you have a pacemaker. Dental drilling may cause your pacemaker rate to increase. Wear an ID bracelet to let other people know that you have a pacemaker. For more information, contact: Medicalert Foundation 2323 COLORADO AVENUE TURLOCK, CA95382 Phone: Phone: Let all your caregivers know you have a pacemaker. Certain surgeries or treatments can be harmful to your pacemaker.

6 When is my next medical appointment? You will need to see your caregiver after your pacemaker procedure. Your caregiver will check your pacemaker to make sure it is working okay. Your caregiver will also check for signs of infection. The bandages covering your incision may also be removed. You will need to see your caregiver 3 to 6 times a year as long as you have a pacemaker. You will also see an electrophysiologist. This is a caregiver specially trained to work with your pacemaker. An electrophysiologist will make any changes in your pacemaker settings and will also check the battery regularly. The battery in your pacemaker usually lasts 5 to 10 years. Your caregiver will check the battery and decide when your pacemaker needs a new battery. Sometimes a special wand may be held over the pacemaker and this will tell your caregiver if your battery is low. A telephone or a portable AM radio may also be used to check the battery in your pacemaker. If your caregiver tells you to use a telephone, you will be given a number to dial. When you get a connection, you will hold the phone up to your pacemaker. The phone will send information about your pacemaker battery to your caregiver. If your caregiver tells you to use an AM radio, you will need to hold the radio close to your pacemaker. The radio will send information about your pacemaker battery to your caregiver. Wellness hints: Eating and drinking: Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet. Follow your caregiver's advice about how much liquid you should drink each day. For most people, good liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these should also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty. Start exercising: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising can help make your heart stronger, lower your blood pressure, and keep you healthy. Quit smoking: It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting. Avoid stress: Stress may slow healing and cause illness. Since it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing. Talk to your caregiver about things that upset you. CONTACT A CAREGIVER IF: You have a fever.

7 You have swelling of your feet or ankles. The area around your ICD is painful or tender after surgery. The skin around your stitches is red, swollen, or has drainage. This may mean that you have an infection. You have a chills, a cough, feel weak, or achy. These are also signs of infection. Your skin is itchy, swollen, or has a rash. You may be allergic to your medicine. You are sad or anxious and you find it hard to do your normal activities. SEEK CARE IMMEDIATELY IF: You become too dizzy to stand, or you pass out. You feel your heart suddenly beating very slowly. You start having chest pain that does not go away with rest or medicine. Your stitches come apart. Your bandage becomes soaked with blood. You have trouble breathing Thomson Reuters. All rights reserved.

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