What is pacemaker placement in children?

A pacemaker is a small battery-powered device. It sends electrical signals to the heart to keep the heartbeat steady. Thin wires, called leads, carry the signals between the pacemaker and the heart. This surgery may be done if your child has a condition such as a slow heart rate (bradycardia).

Your child will get medicine before the procedure. This helps your child relax and helps prevent pain. The doctor will make a cut in the skin just below your child's collarbone. The cut may be on either side of the chest. The doctor will put the pacemaker leads through the cut. The leads go into a large blood vessel in the upper chest. Then the doctor will guide the leads through the blood vessel into the heart. The doctor will place the pacemaker under the skin of your child's chest. The doctor will attach the leads to the pacemaker. Then the cut will be closed.

The procedure may take about 1 or 2 hours. Your child may need to spend the night in the hospital.

Pacemaker batteries may last about 10 years. If the battery gets low, you and your child's doctor can talk about whether your child will need to have another surgery to replace the pacemaker.

Your child can likely return to their usual routine about 1 to 2 weeks after surgery. But for at least a few weeks after the surgery, your child may have restrictions on moving their upper body. They will also need to be careful with certain electric devices. You will get more information after your child gets their pacemaker.

If you or your child is worried about the procedure, it may help to learn about how the pacemaker helps their heart. Talk to your child's doctor if you have any questions.

How do you help your child prepare for the procedure?

Procedures can be stressful for you and your child. This information will help you both understand what to expect. And it will help you and your child safely prepare for the procedure.

Preparing for your child's procedure

• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Help your child follow the doctor's instructions about which medicines to take or stop before the procedure.
• Tell your child's care team if your child has any special needs.
• Ask about the side effects your child might have from anesthesia.
• Follow any other instructions the doctor gave for your child. Because of the pacemaker, your child may need to keep a distance from certain electronic devices.

What happens on the day of the procedure?

Here are some things you can expect before your child's procedure.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, your child's procedure may be cancelled. If your doctor told your child to take medicines on the day of the procedure, have your child take them with only a sip of water.
• Follow the doctor's instructions about when your child can bathe or shower before the procedure. Do not apply lotions, deodorants, or nail polish.
• Have your child take off all jewellery and piercings. And do not let your child wear contact lenses. Bring your child's glasses or contact lens case.

At the hospital or surgery centre

• You and your child may talk with a child life specialist. This person can answer questions about the procedure and ease some fears and anxiety you or your child may have.
• Your child's wristband will be checked. You also may get a badge or wristband.
• You may talk to your child's doctor about the surgery. The nurse will help your child get ready.
• The area of your child's body that needs surgery may be marked. This is to help make sure that there are no surgical site errors.
• Your child will be kept comfortable and safe by the anesthesia provider. The anesthesia may make your child sleep. Or it may just numb the area being worked on.
• The doctor or nurse will tell you when you can likely rejoin your child in the recovery room. This will be as soon as possible.
• The procedure may take about 1 or 2 hours.

When should you contact your doctor?

• You or your child has questions or concerns.
• You don't understand how to help your child prepare for the procedure.
• Your child becomes ill before the procedure (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about your child having the procedure.