Pacemaker Implantation

Paying for the pacemaker

A pacemaker is a “prosthesis” and so is covered by all levels of health insurance.  The health fund will usually pay the hospital or the pacemaker company directly. Veterans Affairs patients and public patients will not receive any account for the pacemaker.  If you are in a private hospital the account for my fees goes directly to your insurance fund so you will not be out of pocket.  If you are a public patient in a public hospital there are no fees.   

Possible Problems

You may get significant bleeding or bruising at the pacemaker site.  This is more common if you are on drugs to stop blood clotting.  Let me know if this occurs.  At no time should a needle be inserted into a bruise to drain it.  This is usually unsuccessful and can lead to infection.

The pacemaker implantation

The pacemaker implantation will be performed in the Cardiac Catheterisation Laboratory (the Cath Lab) which is very similar to an operating theatre but with a special x-ray machine.  The staff in the Cath Lab are nurses and technologists.  There may also be a doctor who will assist me with the procedure.  If you have any questions or are concerned in any way please ask me or one of the staff.  Specific questions about why you are having the pacemaker implanted or about the details of the procedure should be directed to me.

Before the pacemaker implantation

Your should not eat or drink for 4 hours before the procedure but you should take all your usual medicines at the usual times with a small glass of water.  A blood test will be taken to check your blood count (haemoglobin), potassium level and kidney function.  An intravenous cannula will be inserted in a vein in your arm.  You will be given antibiotics through the cannula.  If you are allergic to any antibiotics (in particular penicillin, flucloxacillin or gentamicin), please notify me.

Admission to hospital

You will be admitted to hospital either the night before or on the morning of your procedure.  My secretary will give you the details if you are to be admitted to a private hospital.  The booking officer of the Royal Melbourne Hospital will send you the details if you are to be admitted to RMH.   If you take WARFARIN (Coumadin or Marevan), or  CLOPIDIGREL (Iscover or Plavix), drugs to stop blood clotting, you must notify my secretary or me as soon as possible.  You may need to stop these drugs several days before the procedure and resume them afterwards.  We will tell you the exact details.

How reliable are pacemakers?

Pacemakers are very reliable.  They undergo extensive testing by the manufacturer and are registered by the Therapeutic Goods Administration of the Australian Government Department of Health and Aged Care.  However, problems may occur rarely in a tiny number of pacemakers relative to the total number implanted each year.  Obviously, I do not use pacemakers that are known to be faulty!  If I am notified of a problem (“safety alert”) that affects your pacemaker, I will let you know promptly.  Sometimes pacemaker replacement will be required.

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