Follow-up guide for patients

Pacemakers Follow-up guide for patients

1 Follow-up guide for patients

Introduction After the procedure This leaflet has been written to There are some things you may provide information about the need to consider after your follow-up care arrangements operation. Here are a few rules for the pacemaker device that you should follow. was implanted to help correct abnormal heart rhythms.

We hope it answers some of the questions or concerns you may have about living with a pacemaker and follow-up care arrangements. It is not intended to replace talking with medical or nursing staff.

1 Follow-up guide for patients

Do... Don’t... • Always carry your pacemaker • Don’t get too close to a strong ID card and the Trust’s magnetic field, eg spot or arc helpline numbers with you welding • Keep your mobile phone • Don’t touch the pacemaker on the other side of your site, particularly soon after the body at least six inches away procedure. You will be advised from your pacemaker, and about how to look after your use the opposite ear to your wound pacemaker • Don’t put small magnets near • Be careful with anti-theft your pacemaker, eg the magnets devices in shops (often cats wear to activate cat flaps, hidden near the entrance). magnets to hold scarves in place Walk through them at a • Don’t have an MRI scan normal pace and don’t stop unless you have specifically in the middle or too close been advised it is safe to do either side so (CT scans are safe for your • Tell your cardiologist, cardiac pacemaker) physiologist or arrhythmia • Don’t change your heart specialist nurse of any medications (particularly beta worries or anxieties you blockers and antiarrhythmic might have drugs such as amiodarone) or • Keep your appointments stop your heart medication with your cardiologist and without checking with your physiologists cardiologist, cardiac physiologist • Tell your doctor, dentist and or arrhythmia specialist nurse other clinicians about your • Don’t take part in any contact pacemaker as it may affect sports that could result in your treatment a blow to your pacemaker • Ask for help if things are without discussion with your difficult. Our contact details cardiologist, cardiac physiologist are in this leaflet. Please or arrhythmia specialist nurse don’t hesitate to get in touch • Don’t be afraid to ask questions • Enjoy life 2 Follow-up guide for patients

Back at home How much can I move my Most people adapt fairly arm? quickly to having a pacemaker It is important to allow time implanted and are able to lead for the device to settle in. a relatively normal life after We advise that you should making a few adjustments. not lift the arm nearest your However, many people find pacemaker above your head they have some questions or stretch behind your back when they get home. Some for the first month. However, common ones are listed here. do keep your arm mobile to avoid shoulder stiffness by How can I care for my doing normal activities such as pacemaker wound? washing, dressing and eating. The dressing over your wound is waterproof so you may Once the first month is over, shower as usual. You should gradually increase your activity remove the dressing yourself and arm movements over the after four days and leave the next few weeks. wound uncovered. The stitches are under the skin and are Can I exercise? dissolvable so there is no need Other medical conditions you to have them removed. have may limit your exercise but the pacemaker will not. It It is normal to have some is important to build up your bruising and this should level of exercise over several resolve within two to three weeks. Your cardiologist, weeks. However, if you have cardiac physiologist or any signs of infection such arrhythmia specialist nurse will as increased pain, redness, be able to advise regarding swelling or discharge around safe exercise limits. the wound, or if the wound area feels hotter than the Activities involving repetitive surrounding skin or you have arm exercise such as swimming, a raised temperature, contact rowing and golf should be the arrhythmia specialist nurses avoided for two to three for advice and support. months. It is advisable not to play contact sports as these 3 Follow-up guide for patients may damage the pacemaker. Can I go on holiday or travel Please discuss specific sports or abroad? activities with the arrhythmia The pacemaker will not restrict specialist nurse as sometimes you with any form of travel, special protection is possible. although your cardiologist may advise against this if your How soon can I drive after general condition is likely to implantation? cause problems. The regulations regarding driving are complex and Take details of your device, subject to change. You will not and sufficient supplies of your be able to drive for a period medication. It is very important of time after your pacemaker that your medication is carried implantation. This could be in your hand luggage in case either one week or one month of delays or problems during depending on the reason the your travel. pacemaker was implanted. It is essential that your holiday We recommend you check the insurance company is aware current driving restrictions that you have a pacemaker. with the DVLA. Your cardiac physiologist will be able to Your clinic or pacemaker advise you about the rules manufacturer will be able to related to your situation. give you a list of pacemaker clinics in any country you are If you find a seatbelt visiting. Please contact the uncomfortable, we arrhythmia specialist nurse recommend placing extra if you have any queries or padding over the pacemaker concerns about spending time site. As a passenger, try sitting abroad. behind the driver, so that the seatbelt crosses the other If you are due a follow-up shoulder. soon we would advise you arrange to have this before you go away (please contact us if you need to change an appointment). 4 Follow-up guide for patients

Can I go through security Are there any restrictions gates and metal detectors? regarding special Anti-theft systems in shops environments? and airports can interfere with Modern pacemakers are rarely pacemakers, but they are safe affected by common electrical provided that you go through environments. However if you at normal pace. work closely with high levels of electro-magnetic radiation Sometimes these systems it is important to discuss may set off the alarm, this with one of the cardiac therefore, please advise airport physiologists. security staff that you have a pacemaker before going Visiting through the archway detector. If you are spending time in We recommend that you carry hospital, let hospital staff your ID card as you go through know that you have an security to highlight the reason pacemaker. Usually this will for the alarm. not affect your treatment, but in some instances we may need Can I use a microwave oven, to adjust the settings of your computer and other domestic pacemaker before or after electrical equipment? your procedure. Most household appliances are not a problem as long as You must not have an MRI scan they are well maintained and (body imaging scan) unless you regularly serviced. Although have an pacemaker especially it cannot be categorically designed to be compatible ruled out, any CE marked (please contact us if you are domestic electrical appliances not sure about your device). are unlikely to affect an This is because the MRI scanner pacemaker. Computers should uses strong magnets; other not affect your pacemaker. scans are safe.

As a rule, do not place Pacemakers may not be anything containing strong compatible with therapeutic magnets over the pacemaker radiation dosing, TENS site. machines and lithotripsy. 5 Follow-up guide for patients

Please ask your cardiac heart failure, this is called physiologist for advice before Cardiac Resynchronisation having these treatments. Therapy (CRT).

How long will the battery in my CRT pacemakers completely pacemaker last? take over the stimulation of This depends on use and the the heart, so every impulse type of pacemaker you have, comes from the pacemaker. but your battery is likely to If you have a CRT pacemaker, last several years. Battery life is although you may not be monitored at every pacemaker aware of the pacemaker, you check. When the time comes may see a change in your heart that we need to consider failure symptoms. changing the pacemaker, you will need to have another What are my follow-up care procedure to replace it. arrangements? It is important that you Will I know when my attend regular check-ups at pacemaker is working? a pacemaker clinic. These Your pacemaker will be set may be at three to twelve to send electrical impulses to month intervals depending stimulate your heart to beat on the type and age of your if your heart’s own natural pacemaker. Some devices can pacemaker does not send a be monitored remotely. If this normal impulse. applies to your device, the procedure will be explained by You are unlikely to be aware a cardiac physiologist at the of your pacemaker working pacemaker clinic. but if you have had a very slow heart rate before it was Routine follow-ups are implanted, you may be aware specifically to check your your heart is beating faster. pacemaker and do not replace your normal medical Some types of pacemaker are management in any way. designed to synchronise the pumping chambers of the heart in people suffering from 6 Follow-up guide for patients

What is the pacemaker Who do I contact if I have registration card or form? concerns about my care at This is identification ID for Royal Papworth Hospital? your device: it has the make, The Patient Advice and model and serial number of Liaison Service (PALS) is an your device as well as details of independent office based at the original settings. This will Royal Papworth Hospital who be sent to you following your offer a confidential service to implantation; please carry it help you sort out any concerns with you at all times and show you may have about the care it to any doctor or dentist who Royal Papworth Hospital may treat you. provides. PALS Department Always bring your pacemaker Royal Papworth Hospital ID to your appointments. NHS Foundation Trust Biomedical How can I book and change Campus my follow-up appointments? Cambridge It is important that you have a CB2 0AY pacemaker check at least once Telephone: 01223 638896 a year. If you have not had a pacemaker follow-up within the past year, please contact us to book an appointment.

Please inform us if you are unable to attend your appointment so that your slot can be made available to another patient and your appointment can be rescheduled.

If you change your contact details please let us know so that we can keep our records up to date. 7 Follow-up guide for patients

Who can I contact for advice and support?

For advice and support The Arrhythmia Specialist Nurses Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, CB2 0AY Telephone: 01223 638947 Email: Email: [email protected] My pacemaker details:

For appointment bookings Pacing and ICD Department Office Royal Papworth Hospital NHS Foundation Trust Cambridge Biomedical Campus, Cambridge, CB2 0AY Telephone: 01223 639945 My appointment details:

8 Follow-up guide for patients

Are there other organisations that offer advice about pacemakers?

Arrhythmia Alliance - the heart rhythm charity PO Box 3697 Stratford-Upon-Avon Warwickshire CV37 8YL

24hr helpline 01789 450787 Email: [email protected] Website: www.heartrhythmcharity.org.uk

British Heart Foundation BHF Greater London House 180 Hampstead Road London NW1 7AW

Heart helpline 0300 330 3311 Email: [email protected] Website: www.bhf.org.uk

DVLA Drivers Medical Group DVLA Swansea SA99 1TU

Telephone: 0300 7906806 Email: [email protected] Website: www.dft.gov.uk/dvla

Further information about health issues that affect driving Website: www.direct.gov.uk/driverhealth

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Royal Papworth HospitalFollow-up NHS Foundation guide for patients Trust Papworth Road Cambridge Biomedical Campus Cambridge CB2 0AY Tel: 01223 638000 www.royalpapworth.nhs.uk A member of Cambridge University Health Partners

Author ID: Arrhythmia Specialist Nurses Large print copies and Department: Electrophysiology Reprinted: May 2019 alternative language Review date: May 2021 versions of this leafl et Version: 5 Leafl et number: PI 52 can be made available © 2019 Royal Papworth Hospital NHS Foundation Trust on request.