Post-Operative Precautions After Micra Implantation

Immediate Post-Operative Care

The implant site should be evaluated for signs of infection, hematoma, or other complications before discharge, and a 12-lead ECG should be performed to confirm proper pacemaker function, and chest radiographs should be obtained to verify device position and rule out pneumothorax, and appropriate programming of primary pacing and sensing parameters should be completed before discharge, according to the American College of Cardiology 1
Continuous cardiac monitoring is essential in the immediate post-operative period, as recommended by the American Society of Anesthesiologists 2

Patients should avoid driving for at least 7 days after implantation to allow for proper healing, as recommended by the American Heart Association 3
Limit arm movement on the side of the implantation for approximately 4-6 weeks, and avoid lifting objects heavier than 5-10 pounds during the healing period, according to the American College of Cardiology 1

Keep the incision site clean and dry for the first week, and avoid submerging the incision in water until it is completely healed, and monitor the incision site for signs of infection including redness, swelling, warmth, or drainage, as recommended by the American College of Cardiology 1

The first follow-up visit should be scheduled 4-6 weeks after implantation, and subsequent visits should be scheduled according to device type and patient needs, according to the American College of Cardiology 1
Device interrogation should be performed at each follow-up visit to assess battery status, lead parameters, and event logs, as recommended by the American Heart Association 3

Patients should be advised about potential electromagnetic interference sources, as recommended by the American Heart Association 3
For future surgical procedures involving electrocautery, the electrosurgical receiving plate should be positioned so the current pathway does not pass through or near the device, and short, intermittent, and irregular bursts at the lowest feasible energy levels should be used, and consider using bipolar electrocautery or ultrasonic scalpel instead of monopolar systems when possible, according to the American Society of Anesthesiologists 2

MRI is generally contraindicated in patients with conventional cardiac devices, as stated by the American Society of Anesthesiologists 2
For MRI-conditional devices, MRI at 1.5T can be performed safely following manufacturer instructions, according to the European Society of Cardiology 4
If MRI must be performed, consultation with the ordering physician, cardiologist, radiologist, and device manufacturer is required, as recommended by the American Society of Anesthesiologists 2

Patients should carry proper identification and information about their device at all times, as recommended by the American Heart Association 3

Device-related anxiety should be monitored, as recommended by the American Heart Association 3