Pacemaker Placement in Children: What to Expect at Home

Pacemaker placement is surgery to put a pacemaker in your child’s chest. This surgery may be done if your child has a slow heart rate (bradycardia). Your doctor made a cut (incision) in your child’s chest. The doctor put the pacemaker leads through the cut, into a large blood vessel, then into the heart. The doctor put the pacemaker under the skin of your child’s chest and attached the leads to it.

Your child’s chest may be sore where the doctor made the cut. Your child also may have a bruise and mild swelling. These symptoms usually get better in 1 to 2 weeks. You may feel a hard ridge along the incision. This usually gets softer in the months after surgery. You may be able to see or feel the outline of the pacemaker under their skin.

Your child may be able to go back to their usual routine 1 to 2 weeks after surgery. But for at least a few weeks after the surgery, your child may have restrictions on moving their upper body. You’ll want your child to avoid physical activity that involves their upper body.

Pacemaker batteries may last about 10 years. If the battery gets low, you and your child's doctor can talk about whether your child will need to have another surgery to replace the pacemaker.

You'll need to help your child take steps to safely use electric devices. Some of these devices can stop their pacemaker from working right for a short time. Check with your doctor about what to avoid and what to keep a short distance away from their pacemaker. For example, they will need to stay away from things with strong magnetic and electrical fields. An example is an MRI machine (unless their pacemaker is safe for an MRI). Your child can use a cell phone and other wireless devices, but have them keep these at least 6 inches away from their pacemaker. Many household electronics don't affect a pacemaker.

• Have your child rest when they feel tired.
• Help them be active. Walking is a good choice.
• Have your child do their best not to raise their arm (on the side of their body where the pacemaker is located) above shoulder level until their doctor says it's okay. This helps keep the pacemaker and leads in place while your child heals. Your child’s doctor may recommend gentle range-of-motion exercises for your child's shoulder.
• If your child was given a sling, have them wear it as directed by their doctor.
• Have your child avoid wearing a backpack or purse on the side of the pacemaker until their doctor says it's okay.
• For at least 3 or 4 weeks, or for as long as your child’s doctor says, have your child avoid activities that strain their chest or upper arm muscles. This includes avoiding activities such as swimming or swinging a tennis racquet or any activities where they are pushing, pulling, or lifting more than their doctor says is okay.

• Your child can eat their normal diet. If their stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

• Your child’s doctor will tell you if and when your child can restart their medicines. The doctor will also give you instructions about taking any new medicines.
• If your child stopped taking aspirin or some other blood thinner, the doctor will tell you when your child can start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
• If the doctor gave your child a prescription medicine for pain, have them take it as prescribed.
  • Store your child’s prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your child is not taking a prescription pain medicine, ask your doctor if they can take an over-the-counter medicine.
• Do not give your child aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it's okay.

• If your child has strips of tape on the incision, leave the tape on for a week or until it falls off.
• Ask your child's doctor when they can take a shower. When your child showers, have them pat the incision dry. Don't swim or take a bath for the first 2 weeks or until your doctor tells you it's okay for your child.
• They will have a dressing over the incision. A dressing helps the incision heal and protects it. Your child’s doctor will tell you how to take care of this.

• Keep your child’s medical ID card with them at all times that says they have a pacemaker. The card should include the manufacturer and model information.
• Have them wear medical alert jewelry stating that they have a pacemaker. You can buy this at most drugstores.
• Tell all of your child’s doctors, dentists, and other health professionals that they have a pacemaker before they have any test, procedure, or surgery.
• Ask their doctor for a list of electric devices that they might need to keep a short distance from their pacemaker.
• Check their pulse as directed by their doctor.
• Have your child’s pacemaker checked as often as their doctor recommends. In some cases, this may be done from home. Their doctor will give you instructions about how to do this.

Call 911anytime you think your child may need emergency care. For example, call if:

• Your child passes out (lost consciousness).
• Your child has trouble breathing.

Contact your doctor now or seek immediate medical care if:

• Your child is dizzy or light-headed, or feels like they may faint.
• Your child has pain that does not get better after they take pain medicine.
• Your child hears an alarm or feel a vibration from their pacemaker.
• Your child has loose stitches, or their incision comes open.
• Bright red blood has soaked through the bandage over your child's incision.
• Your child has signs of infection, such as:
  • Increased pain, swelling, warmth, or redness
  • Red streaks leading from the incision
  • Pus draining from the incision
  • A fever
• Your child has hiccups often or for a long time.

Watch closely for changes in your child's health, and be sure to contact their doctor if:

• Your child has any problems with their pacemaker.