PM newly implanted and what to expect during recovery...

Hello everyone, my name is Amanda and I had my PM implanted on 3 Nov 2020 due to complete heart block. Totally out of the blue and I'm still coping with this unexpected situation. So lucky that I found this forum and got so many information/ experience sharing from everyone here. (I'm from Hong Kong and there is no this type of platform in my city.)

I have few questions above what I felt after the surgery and how to handle the recovery. Looking forward to get some advices here. (English is not my native language, hopefully I could express myself clearly)

Q1: Pacemaker’s location - my PM was implanted left side under the collarbone and a bit close to the shoulder joint. When I raised my arm up to certain level (below shoulder) or move my arm toward right side, I could feel my PM clearly and feel like it limited my movement a bit, is it normal? And will this feeling subsided after awhile when my body/muscles adjusted to my PM? If yes, normally how long it takes?

Q2: Pacemaker rotating? - It feels like my PM is now rotated upward a little bit and not completely horizontal, like I saw in the x-ray a day after my surgery. It still located at the same area though. Will that (rotation) happen? Or just my imagination? Shall it be concerned?

Q3: When will I able to raise my arm above shoulder? - My doctor told me 3 months and the post surgery information sheet from the hospital mentioned a week - 1 month. So confused.

Q4: I feel like my heart is at the bottom of my throat! - I feel my heart is beating at my throat and some tightness as well. Not all the time, the feeling just come and go. It’s not affect my breathing either. Anyone have similar experience?

Q5: Back to work? - I’m wondering is that too fast if I go back to work next week (only 20 days after the surgery). Will that be not good for recovering? I work in a bank, no need to deal with customer directly. Only computer work. My doctor said should be okay but my boss is worrying for me.

Many thanks!


Greetings to you for a speedy recovery

by Gemita - 2020-11-19 10:49:37

Your English is excellent Amanda.  So soon after surgery, many of your symptoms could be regarded as normal:

Q1 Yes at first my arm and movements felt quite restricted because I was avoiding moving them for fear of pulling my device out.  It took me 6 weeks to get back some reasonable, comfortable arm movement and then up to 3 months for healing to improve.  It will be different for each one of us.  Healing is so individual.

Q2 Pacemaker rotating doesn’t sound right.  You may have seen other posts recently on pacemaker movement.  I cannot say whether this is normal, but if you believe your device has moved, get it checked as soon as possible.

Q3 After six weeks you should be able to safely raise your arm above your shoulder, but again with mixed messages coming from your hospital, you had better clarify with your doctor.

Q4 Yes I had an uncomfortable feeling at the bottom of my throat, especially when I first came round from procedure surgery.  It improved over the next few weeks but sometimes they can touch a nerve during surgery and all kinds of symptoms will surface, but if it continues, ask for a pacemaker check to make sure that there are no obvious signs of problems with the leads or pacing.

Q5 Going back to work after 20 days should be absolutely fine, especially with the type of work you do.


Welcome Amanda!

by Pharnowa - 2020-11-19 14:15:47

I think your English is excellent and you express yourself well!

I am new, having had my PM implanted one week ago. My device did move but it is stable at the moment. Any time you have concerns, definitely  consult your EP/staff. Any good physician welcomes concerns as the relatiinship is a partnership.

Regarding returning to work, it would seem fine to me in the type of work you do and your doctor agrees.. Perhaps your doctor would provide a note to your employer specifying a date that is acceptable.

I feel my device on movement of my arm and it does feel strange at times. However, it's important to keep moving that arm, within the range you've been told, to avoid frozen shoulder. You can even do helpful, gentle movement while at your desk.

Best wishes to you for a smooth recovery,!


Adding to Gemitra's comments

by Gotrhythm - 2020-11-19 14:45:56

Your English is at least as good as the average American's and more than adeqate for the job. :-)

Unless your surgeon did a sub-pectoral implant, the pacemaker is implanted just under the skin. It's to be expected that you would to be able to feel it. A certain amount of movement is to be expected and is even desirable. Not moving at all can lead to problems. As the area heals what keeps the pacemaker in place is just a stitch or two while scar tissue develops. Even after the incision is closed, healing is still going on on the inside. In time the pacemaker and the leads will be completely embedded in scar tissue.

Try to keep your hands off it. You don't want to be carrying germs to the area or disturbing the normal scaring-in process.

About raising your arm. You should check with your doctor's office to resolve the discrepancy. 3  months sounds like a long time to me. Six weeks is far more usual in the US. Even if you don't raise your hand above your shoulder, do use your hand and arm. Rather than the pacemaker, It more likely that the restricted movement you feel is the result of stiffness arising from lack of stretching and exercise in that area. 

Raising your arms

by Corgi Mom - 2020-11-19 20:13:19

As a recent pacemaker recipient, also unexpected, although the doctor said I could start exercising after 6 weeks, it was very uncomfortable.  I decided to wait longer and after 10 weeks, it was much better.  I still don't raise my arms all the way straight up.  I think everyone has to do what feels best for their own body.  It does feel strange to have the pacemaker at first but I think you get use to it.  It's only been 3 months for me.

Welcome Amanda!

by AgentX86 - 2020-11-19 22:28:10

Q4: Why did you need a pacemaker?  What sort of pacemaker?  It's probably nothing, rather like others have said.  There are some unusual conditions that can cause these sorts of symptoms, as well.  It's highly unlikely to be dangerous but you should tell your doctors what you're feeling.  Without a doubt you'll be told "it's normal" but it's good to get it out there anyway.

Q5:  Going back to work.  You're more than ready, time wise, for what you do.  I was back at work the next day (I also do mostly computer work).


Big thanks to everyone!

by amanda_shanti - 2020-11-20 06:58:20

Hi all, thank you so much!

This forum became so important to me, because no one know how I feel like you all do. My family and friends are very supportive, however they just can't completely understand how I feel now and what I worry about. 

About the PM position, I just texted my Cardiologist about the rotation issue and still waiting for her reply. Hope it's not a big isssue (fingers crossed). I also have a scheduled appointment mid of December, may have a more detailed discussion with my doctor.

@AgentX86, I was told that I need a pacemaker because of complete heart block. My PM is Biotronik Edora 8 DR-T and 100% pace at the moment. My doctor adjusted the PM setting in my post surgery checking (3 days ago). She said something about setting more millisecond in between the pace, so that my ventricle will not completely rely on the PM. I will discuss with her about this feelings of my throat with her in my next appointment.

P.S. I found that most of you have the post surgery follow up with a EP and PM clinic. It's a bit different here in Hong Kong. All our follow up is continue with the Cardiologist surgeon who performed the surgery and doctor will also arrange a PM tech person for PM checking in the follow up meeting.


by AgentX86 - 2020-11-20 18:52:39

If you're feeling your pulse in your throat (not with your fingers but just sitting there) blood may be backing up from the heart.  Though I haven't heard it happen from simple heart block but sometimes the upper and lower heart are out of sync causing the heartbeat to pump some of the blood back into the veins.  This can then be felt (and sometimes seen) in the neck.  like I said, I haven't heart of it because of a HB but it's possible, I think.  Since your cardiologist has changes settings, does it still happen?  Did you say something about it?

It's not all that different here.  We talk a lot about EPs doing the surgery but my cardiologist also does PM implants and the device clinic is in his office.  He's known as an "interventional cardiologist" who does pacamaker implants but generally passes anyone with complicated electrical issues off to an EP.  I originally went to him with Afib but also blocked arteries.  He treated me for both (a thoracic surgeon did my bypass) and continued until it was clear that I needed an EP to fix the electrical problems.  He didn't implant my PM but would have if he hadn't referred me to an EP.

You know you're wired when...

You always have something close to your heart.

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