Living confidently with a pacemaker

Understanding your pacemaker

A pacemaker is a small device, implanted under the skin near the collarbone with one or more leads running to the heart, that watches your heart's own electrical rhythm and steps in with a tiny electrical impulse whenever it beats too slowly or pauses. It does not shock the heart, and it cannot deliver a shock — that is a different device (an ICD), used for a different problem. A pacemaker's whole job is quiet support: keeping the heart rate from dropping too low so the brain, muscles and organs keep getting the blood flow they need.

Most people are surprised by how little daily life changes once the wound has healed. The device sits under the skin, usually barely visible, and the vast majority of ordinary activities — work, travel, exercise, intimacy, driving once cleared, and being around everyday electronics — continue much as before. This page focuses on the practical, everyday questions patients ask most: driving, air travel, phones and appliances, wound care, and what regular follow-up looks like.

A pacemaker may be recommended when the heart's own pacemaker cells fire too slowly, when the electrical signal that normally passes from the upper to the lower chambers is delayed or blocked, or when pauses interrupt the rhythm altogether. These problems can cause tiredness, dizziness, breathlessness or fainting, or sometimes cause no symptoms at all and are found on a routine ECG. Once fitted, the device does not change how the heart beats when its own rhythm is adequate — it only steps in during the moments the natural rhythm falls short, working continuously in the background without you needing to think about it.

Your first few weeks: wound care

• ●A firm, coin-sized lump under the skin near the collarbone is normal and usually settles as the pocket heals
• ●Keep the wound clean and dry as instructed, and avoid soaking it (baths, swimming) until your team confirms it is fully healed
• ●Some bruising and mild discomfort at the site is common in the first days to weeks
• ●Avoid raising the arm on the device side above shoulder height, or lifting anything heavy with that arm, for the period your team advises — this protects the leads while they settle into position
• ●Wear loose clothing over the site while it heals, and avoid tight bag or seatbelt straps pressing directly on it where possible

Driving, travel, phones and appliances

Driving

Most people can return to driving a private car once their team confirms the wound has healed and no complications occurred, typically after a short recovery period your clinician will confirm for you individually; rules can differ for commercial or professional drivers, so ask specifically about your situation.

Airport security and travel

Tell security staff about your pacemaker before screening. A hand-search alternative to walking through the metal-detector arch is usually available, and if a hand-held wand is used, ask that it not be held directly over the device for longer than necessary. Carrying your device identification card makes this straightforward at any airport. The device itself does not stop you flying, and altitude and cabin pressure are not a concern.

Mobile phones and everyday electronics

Mobile phones, televisions, microwaves, induction hobs, laptops and most household electronics are safe to use normally. As a simple precaution, avoid resting a phone directly against the device site for long periods and keep strong magnets (including some phone cases, wireless earphone cases and speaker magnets) a short distance from the pocket.

Work and equipment

Strong electromagnetic sources — certain industrial welding equipment, some heavy machinery, and powerful magnets used in some workplaces — can occasionally interfere with a pacemaker's function and need caution or avoidance. If your work involves this kind of equipment, discuss it specifically with your care team.

Exercise, sport and everyday activity

Gentle activity is usually encouraged from early in recovery, building up gradually once the wound has healed and your team confirms it is safe. Walking, swimming and most low-to-moderate exercise are generally fine once cleared; contact sports and activities with a high risk of a direct blow to the device site are usually discussed individually, since a hard knock to the pocket can move the device or leads. Ask your team about any specific sport or activity you are keen to return to, rather than assuming a blanket restriction applies.

Medical procedures

Always tell every clinician, dentist and radiographer about your pacemaker before any procedure. Ask your device team before an MRI scan, certain surgeries, or treatments using strong electrical currents (such as some physiotherapy machines) — many can be done safely with the right precautions, but this should be checked in advance rather than assumed.

Device checks and battery life

A pacemaker's battery is designed to last many years, but it is finite, so regular checks matter even when you feel completely well.

• 01
  Wound check. A review shortly after implantation to confirm healing is progressing well.
• 02
  Device interrogation. A painless clinic check, using a device held near the pocket, that reads how the pacemaker has been working and how much battery life remains.
• 03
  ECG and symptom review. Confirms the heart's rhythm and checks in on how you are managing day to day.
• 04
  Generator replacement planning. Years later, when the battery is approaching the end of its life, a straightforward planned procedure replaces the generator; the leads usually do not need to be replaced at the same time.

Everyday self-care

• ✓Carry your device identification card at all times
• ✓Keep every device-check appointment, even when you feel completely well
• ✓Tell every clinician, dentist and security officer about your device before any relevant procedure or screening
• ✓Report new fainting, dizziness or breathlessness promptly rather than waiting for your next scheduled visit
• ✓Most people can return to regular exercise once healed — ask your team about any activity you are unsure of
• ✓Intimacy and normal daily activity are generally safe once the wound has healed; raise any specific concerns with your clinician

Preparing for your appointment

What to bring

• ✓Your device identification card
• ✓A list of all medicines you take, including herbal and over-the-counter preparations
• ✓Your HMO card or payment details
• ✓A valid means of identification

What we will ask

How the wound has healed, any new symptoms since your last visit, and how you are managing daily activities, travel and work around the device.

Questions worth asking us

• ●When can I resume driving, exercise and my normal activities?
• ●What should I do at airport security?
• ●Is there any equipment at my workplace I should avoid?
• ●How long is my battery expected to last?