Treating atrial fibrillation with pacemakers: safety precautions

If you have atrial fibrillation, or a heart arrhythmia, a pacemaker can give you your life back. But, this delicate device needs to be well-maintained and there are certain safety precautions you should know about.

• A pacemaker is a battery-driven unit, roughly the size of a matchbox, designed to provide regular electrical stimuli to control your heart rate.
• It consists of an impulse generator implanted just under the skin in your upper chest, and pacing lead wires that descend through a vein directly into the heart muscle itself.

The implantation requires minor surgery performed under local anesthesia, followed by a day or two of recovery in the hospital. You can usually return to your normal activities within two weeks.

The unit will need periodic testing and calibration, which now can sometimes be done over the phone lines. The battery must be replaced every eight to 10 years, a procedure that often requires only local anesthetic.

Receiving a pacemaker may allow you to quit taking anti-arrhythmic and other drugs, thus freeing you from their side effects.

• You should be monitored regularly, wear a medical identification tag and register with the manufacturer of your unit.
• Because pacemakers can be affected by strong electromagnetic fields (EMFs), magnetic resonance imaging (MRI) should be avoided.
• Common household items that produce EMFs (microwave ovens, cellular phones) can be used safely, although cellular phones should be kept at least 30 centimetres (12 inches) away from your chest. Security devices pose no known threat, but try to move quickly through them.

• Be sure to inform surgeons or dentists that you have a pacemaker, so they don't use an electrocauterization device to control bleeding. It can alter pacemaker settings.
• Prior to any medically invasive procedure, ask your doctor about taking antibiotics to prevent infections that may affect the pacemaker.
• Avoid blows to the body near the site of your pacemaker during physical activities. Consult your doctor if you do receive such a blow.
• Check your pulse regularly to see if your pacemaker is operating at the intended rate.
• Report any unusual symptoms to your cardiologist immediately.