Why do I need a device change?
Your pacemaker or other implanted heart device may need to be changed if:
- The device battery is “dead.” We will check the battery during your follow-up appointments. These checks help your doctor know how much life is left in the battery and when the device will need to be replaced.
- A newer device with different features may better meet your needs.
- The device has malfunctioned.
Before the Procedure
Get your procedure time
Call 800.223.2273, and ask for the EP scheduling nurse, Pager 21215, between 3 p.m. and 5 p.m. the day before your procedure. If your procedure is scheduled on a Monday, please call the Friday before the procedure. If your procedure is scheduled on a holiday, please call the last business day before the holiday.
Should I take my medicine?
Ask your doctor which medications you should stop taking and when to stop taking them. Do not stop taking any medicine, including blood thinners or anticoagulation medicine, unless your doctor tells you to.
Can I eat?
Eat a normal meal the evening before your procedure. DO NOT eat, drink or chew anything after midnight the night before your procedure. This includes gum, mints, water, etc. If you need to take medications, take them with only small sips of water. Do not swallow any water when you brush your teeth.
What should I wear?
- Do not wear makeup or nail polish.
- Do not wear jewelry (including wedding rings).
- Wear comfortable clothes. You will wear a hospital gown during the procedure. We will give your clothes to the person who comes with you to the hospital.
What should I bring?
- Any personal items you may need in the hospital. You will not need these until after the procedure. The person who comes with you to the hospital can bring them to you.
- A one-day supply of your prescription medications. Do not take any medicine without first asking your doctor or nurse.
Where is the procedure performed?
The device change procedure is done in the Electrophysiology Lab.
What happens during the procedure?
A nurse will help you get ready. You will lie on the procedure table and get an IV. The IV is used to give you medications and fluid during the procedure.
To prevent infection:
- You will get an antibiotic through your IV.
- Men: We will shave the part of your chest used for the procedure.
- We will wash your chest with an antibacterial soap.
- We will cover you from your neck to your feet with sterile paper sheets (drapes).
- A soft strap will be placed across your waist and arms so your hands don’t touch the sterile area.
Will I be awake?
You will be awake, but get IV medication to make you drowsy.
Will I be monitored?
We will closely watch you during the procedure. You will be connected to several monitors:
- Electrocardiogram (EKG) - to monitor your heart rate and rhythm.
- Defibrillator/pacemaker/cardioverter - in case we need to adjust your heart rate or rhythm.
- Blood pressure monitor.
- Oximeter - to keep track of your oxygen level.
- Fluoroscopy (a type of X-ray).
How is my new device put in place?
Your doctor will make an incision above the device. The device is disconnected from the leads and removed. We will test the leads and connect them to the existing leads. The new device is put in the same place as the old device was.
How long does it take to do the procedure?
The procedure itself takes about 2 hours.
What Happens After the Procedure?
Will I have to stay in the hospital?
If you have leads added or removed, you may need to stay overnight in the hospital. Otherwise, you will spend about 4 hours in a short-stay unit after the procedure. We will use a monitor to constantly watch your heart rate and rhythm.
Is my device checked after the procedure?
We will check your new device in the Device Clinic before you go home. We will attach small, sticky patches (electrodes) to your chest, which are connected to a computer. A wand-like device called a programmer is used to check the device, leads and device settings.
Can I drive after the procedure?
You must have someone to drive you home from the hospital. You will not be able to drive for 24 hours after the procedure because of the medication used to make you drowsy.
Device ID Card
You will get a temporary device ID card before you leave the hospital.
Keep the card with you at all times!
The card has information about the type of device and leads you have, the date of the implant procedure and the doctor who performed the procedure. You will get a permanent card from the device company within about 3 months.
How do I care for my incision?
- Look at your incision every day. Contact us if the area is red, swollen or draining.
- Wash your hands before you touch your incision or bandage.
- Do not rub the area with a towel. Instead, blot it dry.
- After you remove the bandage, do not cover the incision.
- Do not use any ointment, cream, etc. on the incision.
- Wear loose clothing over the incision area.
What activity restrictions do I have?
- If you have new leads, do not lift anything that weighs more than 10 pounds for 6 weeks.
- If you do not have new leads, do not lift anything that weighs more than 10 pounds for 1 week.
- Unless you get other instructions, you can return to your normal routine 2 weeks after your procedure.
- Talk to your doctor about when you can return to work.
- Do not go in a pool, hot tub or whirlpool until your incision is completely healed (usually 2-3 weeks).
- It is OK to use microwave ovens, electric blankets and heating pads.
- Use cell phones on the side of your body that does not have your device.
What type of follow-up do I need?
- Your first follow-up appointment will be 6 to 8 weeks after your device change procedure. We will schedule this appointment before you leave the hospital.
- You will have routine device check appointments (remote or in-person).
- ICD checks: Every 3 months. If you have remote checks, you will have one appointment in the Device Clinic each year.
- Pacemaker checks: Remote checks every 3 months plus one in-person visit per year OR in-person visits every 6 months.
When to Call
Call your doctor right away if:
- The incision site is draining, bleeding or oozing more than usual.
- The incision site opens.
- The area around your incision is red, warm or swollen.
- You have a fever higher than 101 degrees Fahrenheit or 38.4 degrees Celsius.
- You have an ICD that delivers a shock before your first follow-up visit or you become unconscious before the device delivered the shock.
If you have questions, concerns or other non-emergency symptoms
- Call the Device Clinic at 216.444.6483 or 800.223.2273, ext. 46483 (M-F, 8 a.m. - 5:30 p.m.).
- If you cannot call during Device Clinic hours, call the HVTI Resource Nurse Line at 888.490.6121 (24/7).
- Patients with an ICD only: If you have symptoms outside of Device Clinic hours, call 800.223.2273 and ask for the EP fellow on call.
If you have a medical emergency, call 911 or have someone take you to the closest emergency department right away!
Visit clevelandclinic.org/arrhythmiacare for more information about arrhythmias and treatment options.
