Pacemaker Surgery Recovery: Learn the Do’s and Don’ts

What are the restrictions when I get home from the hospital?

When your doctor puts in a pacemaker, they place wires called leads in the chamber(s) of your heart, depending on the type of pacemaker you have.

During recovery, it’s important to limit your physical activity to make sure the tissue around the leads has time to heal and that the leads don’t move.

This is why a doctor typically recommends reducing physical activity, lifting, and movement after the procedure. Sometimes, you may go home the same day or stay overnight for monitoring after pacemaker surgery.

Before you’re discharged, a doctor or nurse will give you some do’s and don’ts to follow after pacemaker insertion surgery. These may include:

Do’s

• Do: Obtain a medical device ID card that includes information about your pacemaker, such as the manufacturer and the chamber where the device is placed. You may also consider wearing a medical ID bracelet or necklace.
• Do: Prevent wires from moving. A doctor may recommend avoiding heavy lifting, raising your arms above your head, or strenuous physical activity.
• Do: Try to keep your shoulder relaxed and perform only small motions to prevent the muscles from tensing.
• Do: Talk with your doctor about any changes to your medications.
• Do: Talk with your doctor about when your pacemaker should be checked.
• Do: Eat and drink as you normally would.
• Do: Ask your doctor when it’s safe to engage in sexual activity.
• Do: Call your doctor if you experience any side effects that could mean the pacemaker isn’t working well, including:
  • dizziness
  • chest pain or problems breathing
  • hiccups that don’t go away
  • weight gain or swollen legs and ankles
• Do: Call your doctor if the pacemaker site is red or warm or if you have a fever.

Don’ts

• Don’t: Get the incision site wet according to instructions from your doctor — usually 4 to 5 days.
• Don’t: Wear tight clothing over the incision site to avoid irritating the skin.
• Don’t: Engage in excessive physical activity, including movements like leaning on your arms or stretching your arms overhead or behind you.
• Don’t: Rub your chest area around or near the incision.
• Don’t Lift heavy objects, such as a heavy purse or a dog or cat, especially on the side of the pacemaker.
• Don’t: Drive or operate heavy machinery until you get your doctor’s OK.
• Don’t: Have close contact with devices that may interfere with your pacemaker, especially in the area around where it’s implanted. Keep certain items at least 6 inches from your pacemaker, even after the recovery period has ended. These devices may include:
  • cellphones
  • electronic cigarettes
  • headphones
  • CB and Ham radios
  • security metal detectors
  • EAS anti-theft security systems (in stores near entrances and exits)
  • magnets
  • electronic body fat scales
  • gas-powered motors (it’s safe to drive a car, though)
  • medical alert systems and fall pendants
• Don’t: Undergo some medical procedures or tests. Always let your healthcare professionals know that you have a pacemaker. Procedures and tests to avoid may include:
  • MRIs
  • CT and CAT scans
  • extracorporeal shockwave lithotripsy (ESWL)
  • radiofrequency ablation (RFA) or microwave ablation
  • high frequency, short wave, or microwave diathermy for physical therapy
  • transcutaneous electrical nerve stimulation (TENS)
  • radiation therapy
  • electrocauterization
  • electrolysis

When can I resume my normal activities?

Your doctor will typically advise against strenuous activity for 2 to 3 weeks after your pacemaker insertion.

Exercise

Strenuous activity involves anything that significantly raises your heart rate and requires you to move your body a lot. This includes activities like:

• running
• jogging
• taking an exercise class
• lifting anything that weighs more than 10 pounds (4.5 kilograms)
• twisting
• bending

You should avoid swimming, using a hot tub, or any activity that would submerge the device or your incision underwater.

Your doctor may advise you to avoid lifting heavy items for several weeks after the procedure, including grocery bags. If you run errands outside your home, you may need assistance.

Your doctor may recommend light or moderate exercise, such as walking. These activities are beneficial not only for your recovery but also for your heart and overall physical health.

What are the precautions when living with a pacemaker?

A doctor may share additional recommendations to follow even after you recover from pacemaker surgery.

Medical procedures

Some medical and dental procedures may affect your pacemaker.

Let any other doctors, dentists, and medical professionals you see know that you have a pacemaker. Talk with these healthcare professionals ahead of any upcoming medical or dental procedures, especially those involving magnets or equipment with strong electromagnetic fields.

This may include:

• MRIs
• electrocautery, which can be used during surgery to stop blood vessels that may bleed
• microwave diathermy for physical therapy
• radiation therapy for treating cancer
• shockwave lithotripsy for treating kidney stones
• transcutaneous electrical nerve stimulation (TENS), which treats pain

Other precautions

Avoid close contact with devices that may interfere with your pacemaker, especially in the area around where it’s implanted.

Keep certain items at least 6 inches from your pacemaker. This may include cellphones, smartwatches, and electronic cigarettes.

Travel

When traveling by air, tell a Transportation Security Administration (TSA) agent that you have a pacemaker. While a metal detector is unlikely to harm the pacemaker, it will show up as metal in the TSA screening. The agent may use an alternate screening method, such as using a hand wand.

Physical activity

Staying physically active helps your heart and body. Talk with a doctor about which activities you can do and how soon after surgery.

What does medical follow-up look like?

Technological innovations mean your doctor can check in remotely or in person to see if your pacemaker is working. Information your doctor can find out includes:

• your heart rate and rhythm
• how well the pacemaker is working
• how long the battery will last

Depending on the type of pacemaker you have, your doctor can often change settings in person or remotely.

Although remote pacemaker checks are an option, you’ll still need to visit a doctor for regular appointments. These appointments can include:

• monitoring how well the pacemaker is working
• checking your overall heart health
• updating the pacemaker’s software, if needed
• going over any medications you’re currently taking for your heart health
• addressing any concerns you have about your pacemaker, such as going through airport security or possible cellphone interference

The frequency of your appointments can depend on your overall heart health. For example, you may need to visit a cardiologist yearly or every 6 months.

The bottom line

Doctors implant an estimated 1.25 million pacemakers worldwide each year. Recovery from this procedure often means limiting your physical activity, not because your heart can’t tolerate the procedure but because your body needs time for the pacemaker site to heal.

If at any time you notice complications after pacemaker insertion, call your local emergency services or a doctor.