Pacemaker/ICD insertion is done in the hospital, either in the operating room or the cardiac catheterization laboratory. Your child is under general anesthesia during the procedure.
In older children and teenagers who receive a transvenous pacemaker, a small incision is made just under the collarbone. The pacemaker/ICD lead(s) is inserted into the heart through a blood vessel which runs under the collarbone. This procedure is usually performed in the catheterization laboratory. Once the procedure has been completed, the child goes through a recovery period of several hours and usually stays in the hospital for 48 hours.
In younger children, the pacemaker may be placed into the abdomen through a small incision. A second incision is made in the chest to visualize the heart. The lead(s) are guided to the heart and then placed on the heart's surface. This procedure is performed in the operating room. Once the procedure has been completed, the child goes through a recovery period of several hours and often is ready to go home one to two days after the procedure.
Patients who have a pacemaker or ICD placed will be seen for a follow-up visit and wound check one to two weeks after discharge from the hospital. Another visit is usually scheduled for one month after the procedure and the pacemaker/ICD will be checked again. After the post-operative period, patients are routinely seen by an Electrophysiologist and Pacemaker Nurse every six months if they have a pacemaker and every four months if they an ICD. You will not be allowed to have the wound soak in water (i.e., go swimming or take a tub bath) for one month or until the wound completely heals. For patients that have a transvenous pacemaker or ICD implanted in the upper chest, we recommend not raising the arm above the shoulder level also for one month after the surgery.
After receiving a pacemaker or ICD, you will receive an identification card from the manufacturer that includes information about your child's specific model of pacemaker and the serial number. You should carry this card with you at all times so that the information is always available to any healthcare professional who may have reason to examine and/or treat your child. A medical identification bracelet or necklace can also be worn by your child to alert others about the pacemaker or ICD in case of emergency.