You've had a pacemaker implanted. The most important thing to know is that the device is working from the moment it was placed, and you do not need to think about it for the device to do its job.

This handbook covers the practical questions that come up in the first weeks: how to care for the incision, when you can drive and lift, what activities to ease back into, what to do about MRIs and airport security, and when to call us. Keep it nearby — particularly the contact card on the last page.

If anything in your experience differs from what's described here, that's not unusual; bodies vary. Use the information as a starting point, not a strict script, and call us with anything that worries you.

Your pacemaker has two jobs: sense your heart's own activity, and pace when your heart's rate falls below a programmed threshold. When your heart is doing what it should, the pacemaker stays quiet. When it isn't, the device delivers a small electrical impulse to keep the rate up.

The device sits in a small pocket of tissue just below the skin near your left or right collarbone (whichever side we used). One or two thin insulated wires — leads — run from the device through a vein and into the heart, where they sense and pace.

Battery life depends on how much your pacemaker is working. For most patients, 8 to 12 years is typical. We monitor the battery at each follow-up. When the time comes to replace it, only the generator (the part under your skin) is changed — your existing leads are reused.

The incision

• Keep it dry for 5 days. Shower from the neck down or use a washcloth above. After day 5, you can shower normally; pat the incision dry — do not rub.
• No baths, hot tubs, or swimming for 2 weeks. Submerging the incision before it has sealed is the most common cause of pocket infections.
• Some bruising and a small lump are normal. The lump is the device itself; the bruising spreads down the chest and arm and resolves over 1–2 weeks.
• Steri-strips fall off on their own. If they're still there at 2 weeks, gently peel them off in the shower.

Arm restrictions on the device side

• Do not raise the arm on the device side above your shoulder for 2 weeks. This prevents the new leads from being pulled out of position before they have anchored.
• No lifting more than 5–10 pounds with the device-side arm for 4–6 weeks. Use the other arm.
• Otherwise, use the arm normally — eating, brushing teeth, dressing, light gestures.
• After 6 weeks, there are no restrictions on arm motion or lifting.

Driving

• No driving for 1 week after a standard pacemaker implant. Some patients are restricted longer based on their underlying rhythm.
• If you were having fainting episodes that led to the pacemaker, your driving restrictions may be longer. We will tell you specifically.

Activity

• Walking is encouraged from day one — get up and move every few hours.
• Avoid heavy lifting, push-ups, and arm-intensive workouts for 4 weeks.
• Light cardio (stationary bike, treadmill walking) is fine after the first week.
• Return to your normal exercise routine at 6 weeks unless we tell you otherwise.

Sleeping

Sleep on your back or the opposite side for the first 2 weeks. After that, sleep however is comfortable — you cannot dislodge the device by lying on it.

Showering and bathing

Showers are fine from day 5. Baths, hot tubs, and swimming wait until at least 2 weeks after implant and only after the incision has fully sealed.

Sex

Resume when you feel ready, typically by 2 weeks. The pacemaker does not interfere with sexual function. Avoid positions that put pressure on the device site for the first 2 weeks.

Returning to work

Most desk-job patients return at 3–7 days. Patients in jobs requiring heavy lifting, arm work overhead, or operating heavy machinery should plan for 4–6 weeks.

Clothing

Bra straps, shoulder bag straps, and seat belts can rub the incision. A folded washcloth tucked between the strap and your skin solves it. The friction is more annoying than dangerous — but worth fixing because it can delay healing.

MRI

Your pacemaker is MRI-conditional — meaning MRI is safe under specific scanning protocols. Tell the MRI technologist you have a pacemaker. They will check your device card and follow the right protocol. Do not get an MRI without first telling the staff.

Airport security and TSA

You can walk through airport metal detectors and full-body scanners safely. If you prefer, show your device card and request a hand-search. Modern security equipment does not interfere with the pacemaker but the alarm may go off. Allow a few extra minutes.

Phones, headphones, and household electronics

• Cell phones are safe, but as a precaution, do not carry your phone in a chest pocket directly over the device.
• Bluetooth headphones contain magnets. Keep them more than 6 inches away from the device site. This is rarely a real-world problem unless you sleep with them on a chest pocket.
• Household appliances — microwaves, hair dryers, computers — are safe.
• Strong industrial magnets, MRI machines, large electric motors, arc welding — keep your distance. The device will resume normal function once you step away.

Dental procedures

Tell your dentist you have a pacemaker. Most routine dental work is fine. Electrocautery tools used in oral surgery may need to be modified. The device does not require antibiotic prophylaxis for routine dental cleaning.

Surgery

If you need surgery, the surgical team needs to know about your pacemaker. Tell every surgeon you see, every time. Some types of cautery used in surgery can temporarily interfere with the device; a magnet placed over the device or a brief reprogramming usually solves this.

• You can fly normally. Cabin pressure does not affect the pacemaker.
• Bring your device card in your wallet and a photo of it on your phone.
• Know the brand and model of your device. If you travel internationally, this matters; another country's monitoring centers may need this to interrogate your device in an emergency.
• Pack medications in your carry-on, not checked luggage.
• Plan for follow-ups: remote monitoring covers most check-ins. If you'll be away from home for more than 6 months, let us know so we can verify your transmitter has a signal where you're going.

• 1–2 weeks after implant: Wound check in clinic. We confirm the incision is healing and the device is functioning normally.
• 3 months: Full in-office interrogation. We adjust device settings now that lead positions have stabilized.
• Then every 6–12 months: Routine remote monitoring through your home transmitter, plus an annual in-office visit.
• Battery alert: When the device approaches end-of-life, we typically schedule the generator change 3 months before depletion.

Your home transmitter — a small box that sits on a bedside table or charging dock — wirelessly checks your device daily. You do not need to do anything for this to work; it runs automatically. Keep it plugged in and connected to its network (cellular or Wi-Fi depending on the model).

This handbook is educational. It does not create a doctor-patient relationship and does not replace your visits. Your situation may differ — talk to Dr. Colombowala before making decisions about your care.

© 2026 Ilyas K. Colombowala, MD. All rights reserved.