Ask the Doctor: ‘Since my father got a pacemaker, he’s worried about doing anything. Are there any things he should avoid?’

”My father, 60s, recently got a pacemaker inserted. He has been retired for a number of years and has, until now, enjoyed a very active and fulfilling life. Since the pacemaker, he is worried about doing anything. He regularly travelled but since his pacemaker, he has not set foot on a plane. He used to play with his grandchildren, picking them up and spinning them around but again, this has stopped since the pacemaker. I feel as though he is letting worries get in the way of living his life. Are there any things he really should avoid with a pacemaker, and can he travel and play with his grandchildren again?”

Answer from Prof Jonathan Lyne, Director of Cardiac Electrophysiology and Consultant Cardiologist & Electrophysiologist, Beacon Hospital.

Pacemakers are a common treatment in patients with a slow heart rate and the probability of requiring a pacemaker also increases significantly with ageing. Pacemakers come in a variety of forms, shapes and sizes, and should not impinge or hinder a full and active lifestyle after the initial 4-to-6-week recovery period.

Before a device is inserted, it is certainly advisable to fully discuss the procedure and in particular the position, type and device options with your cardiologist. In many circumstances there may be a range of different devices that would be suitable for any one patient depending on the underlying condition of the heart. This may include the option of a ‘leadless’ pacemaker that is contained only within the heart and therefore has no ‘box’ or leads in or around the chest area. For patients with very active lifestyles this type of device may be very much a preferred option.

The main concern with conventional pacemakers is that the location of the ‘box’ may be tender initially but may in the long term remain superficial enough to be an area of concern to many patients who worry about knocking it. Especially those with young grandchildren! In these instances, conventional pacemakers could be implanted in deeper tissues beneath the chest muscle to reduce such concerns. Regardless of the location and type of device inserted, a pacemaker should not prevent a full range of upper arm and shoulder movement.

Many patients are concerned about the possibility of electrical or magnetic interference with their pacemaker. Technological equipment may cause temporary changes in pacemaker behaviour when placed very close to the device. There is the potential for exposing a pacemaker to electrical or magnetic fields in day-to-day activity around the home with mobile phones, hairdryers, induction hobs, and headphones.

Outside of the home, in particular when travelling through airports, pacemakers need security clearance. All patients should be provided with an identity card for their pacemaker by the implanting hospital. Taking this, or a photocopy of it, allows individuals to identify themselves to security staff as having an implantable device who should then use an alternative screening device, safe to the pacemaker to ensure that no magnetic field is placed near the device that may temporarily affect device function.

Separately to this, if undergoing ultrasonic teeth cleaning, laser hair removal, or other dental/medical procedures, specific guidance to these professionals can be provided for safety.

Ensuring the correct device implanted in the correct position for you as a patient is the best way to ensure it will not alter your quality of life. There are not many restrictions in day-to- day life, just some precautions in specific circumstances. Always seek advice from the pacemaker clinic with any specific questions or concerns you may have.

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