Definition and Overview

A pacemaker checkup is a regular medical appointment required for all patients who have had a pacemaker (a device that regulates abnormal heart rhythms caused by heart diseases such as arrhythmia) implanted.

The device requires regular monitoring to ensure that it is working properly and according to the unique needs of the wearer. This is done by connecting it to a computer using electrodes that are attached to the patient’s body. The procedure is completely safe and is facilitated only by trained technicians.

Who Should Undergo and Expected Results

A pacemaker checkup is a required for every patient who has had a pacemaker implanted as part of the treatment of various heart disorders including bradyarrhythmias (slow heart rhythms) and heart failure.

Pacemakers are electronic devices powered by batteries, which can wear down over time. These devices are programmed to slow down as the batteries start to wear down, but in most cases, the effects of poor battery level are difficult for the patient to detect. A scheduled pacemaker checkup can help check the battery level as a preventative measure.

Some warning signs of malfunction include breathing difficulties, swelling of the legs and ankles, fainting, dizziness, and sudden changes in heart rate.

A pacemaker checkup is recommended:

  • After 24 hours following implantation
  • After six weeks following implantation
  • Three months after the last visit
  • Six months after the 3rd-month visit
  • One year after the 6th-month visit
  • One every succeeding year


The pacemaker is checked for its:

  • Battery level
  • Lead function
  • Specific programming depending on the condition of the patient’s heart
  • Performance at rest and during times of activity


If any abnormalities are found during the checkup, the pacemaker will be adjusted or modified accordingly to meet the goals of treatment and to suit the patient’s current situation.

As the checkup ends, the technician will inform the patient about the status of the device, including its maximum and minimum heart rate limits. The patient will also be reminded about what to watch out for as well as signs of a pacemaker problem that should prompt him to seek medical attention.

If the pacemaker is found to be malfunctioning, is no longer suited to the patient’s heart condition, or simply needs to be replaced, it will be taken out through a minor surgery.

How Does the Procedure Work?

A pacemaker checkup is performed by a licensed and trained technician working in a hospital laboratory or a specialized heart clinic. The patient will be asked to lie down on an exam chair with electrodes connected to his chest and a special magnet placed just over the pacemaker’s location. These electrodes are connected to a computer, controlling the pacemaker and checking if all functions are working properly.

The procedure is painless and does not cause any major discomfort. It usually takes around half an hour or up to 40 minutes. The exact length of time differs based on the type of pacemaker used.

No preparations are needed prior to a pacemaker checkup.

Possible Risks and Complications

A pacemaker checkup is a safe procedure for patients with a heart disease. It is, in fact, a preventative measure used to make sure that there are no problems with the pacemaker and that the patient can live a normal, healthy life despite an existing heart problem.

References:

  • Epstein AE, et al. (2013). 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. Circulation, 127(3): e283-e352.

  • Res JCJ, et al. (2004). Pneumothorax resulting from subclavian puncture: a complication of permanent pacemaker lead implantation. Netherlands Heart Journal, 12(3): 101-105.

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