PreOp Patient Education
Tuesday, July 07, 2020

  Your Body
  Medical Record
  Before Surgery
  Your Procedure

Permanent Pacemaker


Your Procedure

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Now it's time to talk about the actual procedure your doctor has recommended for you.

On the day of your operation,
you will be asked to put on a surgical gown.
You may receive a sedative by mouth
and an intravenous line may be put in.
You will then be transferred to the operating table.
To begin, skin is swabbed with an antiseptic solution
and a sterile drape will be placed around the operative site.
Then the surgeon will make a small skin incision in the upper chest, just below the collarbone.
A pocket is then created between the skin and the tissue that covers the chest muscle.
Next, the team will use instruments called retractors to hold back the skin and underlying tissue. They'll locate a large blood vessel called the subclavian vein.
Using a special needle and syringe, your doctor will puncture the wall of the vein.
A thin guide wire is then inserted through the needle and into the vein. Your doctor gently pushes the wire until it reaches the heart.
Using an instrument called a fluoroscope the surgical team is able to see the wire's progress through the vein and into the beating heart.
Once the wire is in place, the needle is removed
and a catheter - or hollow tube - is passed over the guide wire and into the heart.
One or two leads are then passed through the catheter.
When the lead or leads are in their proper position,
the catheter is removed.
Finally, the lead is connected to the pacemaker,
the pacemaker is inserted into the pocket below the collar bone
and the incision is closed.

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