Life After a Pacemaker: A Guide to Recovery and Long-Term Care

Getting a pacemaker can feel like a major life change. The good news is that most people return to their usual activities and may feel more energetic once their heart rate is better controlled.

A pacemaker is a small device placed under the skin, usually below the collarbone. It watches your heartbeat and sends a gentle electrical signal when your heart is beating too slowly.

This guide explains how to care for yourself after the procedure, what activities to avoid, and what to expect during follow-up visits.

1. Caring for Your Incision

The incision is the small cut where the pacemaker was placed. It needs time to heal.

Keep the area clean and dry

Follow the instructions given by your implanting team. Some dressings must stay completely dry for several days. Other waterproof dressings may allow you to shower sooner.

Do not soak the incision in a bathtub, swimming pool, or hot tub until your doctor says it is safe.

Do not scrub the area

When you are allowed to shower, let water run gently over the area. Do not scrub it. Avoid putting lotion, cream, powder, perfume, or deodorant near the incision until it has healed.

Check the incision every day

Mild soreness, bruising, and a small amount of swelling are common during the first few days. These should slowly improve.

Call your medical team if the incision becomes more red, warm, painful, swollen, or starts draining fluid.

2. Moving Your Arm Safely

Most standard pacemakers have one or more wires, called leads, that travel through a vein into the heart. These leads need time to settle into place.

For the first few weeks, you may be told to:

• Avoid lifting more than about 10 pounds with the arm on the pacemaker side.
• Avoid heavy pushing, pulling, or carrying.
• Avoid repeatedly raising that elbow above shoulder level.
• Avoid reaching far behind your back.
• Avoid sports such as swimming, golf, tennis, or weightlifting.

Do not keep the arm completely still. Gentle movement helps prevent shoulder stiffness. Your care team will tell you how long your restrictions should last. Recommendations may range from about one week to several weeks, depending on the procedure and your doctor's practice.

A leadless pacemaker is placed inside the heart through a blood vessel in the leg. Recovery instructions for a leadless pacemaker are different because there is no chest incision or pacemaker lead running from the chest.

3. When Can I Drive?

Driving rules are not the same for everyone.

You may need to avoid driving for several days or longer, depending on:

• Why the pacemaker was needed
• Whether you fainted before the procedure
• Whether you depend on the pacemaker
• Your doctor's instructions
• Local driving laws
• Whether you drive for work

Do not drive until your cardiologist or device team clears you. Pain, limited shoulder movement, dizziness, or medicines used during the procedure may also make driving unsafe.

4. Can I Return to Work After Two Days?

Some people with desk jobs may feel well enough to return to work within a few days. However, returning after only two days may be too soon for others.

A quick return may be reasonable when:

• Your job is mainly seated or computer-based.
• You are not taking strong pain medicine.
• You are not dizzy, weak, or unusually tired.
• You can follow your arm and lifting restrictions.
• Your doctor has cleared you to return.

You may need more time away if your job involves:

• Lifting, pushing, or pulling
• Reaching overhead
• Construction or heavy machinery
• Driving
• Repetitive arm movements
• Strong magnets or electrical equipment

Some people wait until the first follow-up visit before returning to regular duties. Ask whether temporary light-duty work is an option.

5. What Happens at the First Follow-Up Visit?

The first visit is often scheduled within one to several weeks after the procedure. The timing may vary by clinic and pacemaker type.

Your incision will be checked

The medical team will look for:

• Redness
• Swelling
• Drainage
• Bleeding
• A pocket of blood under the skin
• Poor wound healing

If you have staples or stitches that need removal, they may be removed at this visit. Steri-Strips may be removed if they have not already fallen off.

Your symptoms will be reviewed

Tell the team if you have had:

• Dizziness or fainting
• Unusual tiredness
• Palpitations
• Shortness of breath
• Chest discomfort
• Persistent hiccups
• Swelling of the arm on the pacemaker side

The pacemaker will be checked

A device specialist will perform a painless test called a pacemaker interrogation. A small device is placed over the pacemaker to communicate with it.

The check shows:

• Whether the pacemaker and leads are working correctly
• How often the pacemaker is being used
• The strength of the signal needed to pace the heart
• Whether any unusual heart rhythms were recorded
• The estimated battery life

The pacemaker settings may be adjusted to match your needs and help protect battery life.

Your activity plan will be reviewed

Your doctor may discuss when you can:

• Drive
• Return to work
• Lift heavier objects
• Exercise
• Swim
• Raise your arm normally

Bring a list of questions. This visit is a good time to discuss any fear, anxiety, trouble sleeping, or concerns about living with the device.

6. How Does Remote Monitoring Work?

Many pacemakers can send information to the device clinic from your home. This is called remote monitoring.

Depending on your pacemaker, you may use:

• A bedside monitor
• A handheld reader
• A smartphone or tablet app

The system may connect through a cellular signal, Wi-Fi, or another supported connection.

Setting it up

Your clinic will enroll your pacemaker in the correct monitoring system. The equipment may be given to you at the hospital or mailed to your home.

For a bedside monitor, you may simply need to plug it in near your bed and follow the instructions on the screen.

For an app-based system, you may need to:

• Download the correct app.
• Turn on Bluetooth.
• Pair the phone with your pacemaker or reader.
• Allow the app to run in the background.
• Keep the phone charged and connected to Wi-Fi or cellular data.

Follow the instructions for your specific pacemaker brand. Not all monitoring systems work in exactly the same way.

What information is sent?

Remote monitoring may send information about:

• Battery life
• Pacemaker lead function
• Pacemaker settings
• How often you are being paced
• Certain abnormal heart rhythms

Some information is sent automatically. At other times, the clinic may ask you to send a manual transmission. The clinic reviews the information and contacts you when follow-up is needed.

Remote monitoring does not replace emergency care. It is not watched every second like a hospital monitor. If you have severe symptoms, call emergency services rather than waiting for the monitor to alert your clinic.

7. Cell Phones, Magnets, and Household Appliances

Most normal household appliances are safe when they are in good condition.

You can usually use:

• Microwave ovens
• Televisions
• Toasters
• Electric blankets
• Computers
• Hair dryers
• Washing machines
• Standard kitchen appliances

Cell phones and smart devices

Keep cell phones, smartwatches, wireless earbuds, and other devices containing magnets at least 6 inches away from your pacemaker.

Use the phone on the ear opposite the pacemaker. Do not carry it in a shirt or jacket pocket directly over the device.

Magnets

Keep strong magnets at least 6 inches away from the pacemaker. Be careful with:

• Magnetic phone accessories
• Magnetic jewelry
• Magnetic therapy products
• Magnetic mattress pads
• Large stereo speakers
• Some purses, bags, and tablet covers with magnetic clasps

If an item is making you feel dizzy or unwell, move away from it and contact your device clinic.

Power tools and industrial equipment

Ask your device team before using:

• Arc-welding equipment
• Chainsaws
• Powerful generators
• Industrial motors
• Large magnetic equipment
• High-voltage electrical systems

The risk depends on the strength of the electrical or magnetic field and how close it is to your pacemaker.

8. Medical Tests and Procedures

Always tell doctors, dentists, nurses, physical therapists, and medical technicians that you have a pacemaker.

Many medical tests are safe, but special planning may be needed for:

• MRI scans
• Electrocautery used during surgery
• Radiation treatments
• Certain nerve or muscle stimulators
• Lithotripsy for kidney stones
• Some types of diathermy or heat treatment

Many newer pacemakers are MRI-conditional, which means an MRI may be performed under specific safety conditions. Do not assume that an MRI is unsafe—or automatically safe—without checking the exact pacemaker and lead models.

Carry your pacemaker identification card so the medical team can confirm what device you have.

9. Traveling With a Pacemaker

A pacemaker usually does not prevent you from flying.

Always carry your pacemaker identification card. Keep important medicines in your carry-on bag.

At airport security:

• Tell the security officer that you have a pacemaker.
• Walk through the security gate at a normal pace.
• Do not stand or linger inside the gate.
• A handheld screening wand should not be held directly over the pacemaker for a long time.

Airport metal detectors are not expected to damage a pacemaker, but the device may set off the alarm.

When traveling for a long time, bring the contact information for your device clinic. Ask whether your remote monitor or phone app will work at your destination.

10. When Should I Call the Doctor?

Call your pacemaker or cardiology team promptly if you develop:

• A fever of 101°F, or 38.3°C, or higher
• Increasing redness, warmth, swelling, or pain at the incision
• Pus, fluid, or bleeding from the incision
• The incision opening
• New swelling of the arm on the pacemaker side
• Persistent hiccups
• New dizziness or fainting
• A return of the symptoms you had before the pacemaker
• New palpitations
• Increasing shortness of breath

Call emergency services for severe chest pain, severe trouble breathing, fainting that does not quickly improve, stroke symptoms, or any other medical emergency.

11. Living Well With Your Pacemaker

Feeling worried after a heart procedure is common. Some people become very aware of their heartbeat or feel nervous about moving, sleeping, or being alone.

Talk with your medical team if anxiety is affecting your sleep or daily life. Support from family, friends, a counselor, or a cardiac support group can help.

Once your doctor clears you, regular activity is encouraged. Walking is often a good place to begin. Continue taking your medicines and keep all device-clinic appointments.

Pacemaker batteries often last many years. The exact life depends on the pacemaker settings, how often it is used, and the type of device. The battery is checked at every device visit. When it begins to run low, the pacemaker generator can usually be replaced during a planned procedure before the battery is fully depleted.

Key Takeaway

A pacemaker is meant to help you return to a safer and more active life. Protect the incision, follow the temporary arm restrictions, keep your remote monitor connected, and attend every follow-up visit.

Your own implanting team's instructions should always take priority because recovery plans can differ from one patient to another.