Preparingfor surgery

Tests and imaging

Before deciding to implant a pacemaker or defibrillator, your doctor will order a number of tests and imaging studies to make sure it's the correct approach.

Before implanting a pacemaker or defibrillator you’ll be given one or more of these:

  • An electrocardiogram (ECG)
  • A portable monitor to wear at home for 24 hours or longer
  • A stress test
  • An implantable event recording. This is used when 30 days of ECG recording fails to record an event
  • A heart rhythm study (technically known as a cardiac electrophysiology study or EPS), which is an invasive diagnostic procedure requiring sedation that maps the way in which electrical current is conducted through heart muscle and can show abnormal pathways

Before implanting a defibrillator, you’ll be given one or more of these:

  • An echocardiogram, which records images of your heart using ultrasound
  • Magnetic resonance imaging (MRI), which provides very detailed images of the heart muscle
  • A cardiac cat scan (CT) imaging, which is another way of visualising the heart
  • Cardiac catheterisation and angiogram an invasive test in which dye is injected to visualise the area around the heart to provide details of the heart chambers

If any important problems are detected or if there are any anaesthetic issues, the surgery may be postponed or modified. If other medical conditions are detected, you may be referred to other specialists.

Some health conditions can increase the risks of pacemaker surgery and the associated anaesthesia. Your cardiologist will discuss the best course of action if you have one of them.

What you can do

Common conditions that may affect the outcome of surgery include diabetes, obesity and infection. If you’re overweight or obese, there are increased risks associated with anaesthesia.

If you need support managing your weight, either before or after your procedure, have a look at our 18-week Healthy Weight for Life weight loss program, which is specially designed for overweight people living with heart conditions. It includes activity and portion-controlled eating plans, online tracking plus support via phone, SMS and email. The program is free to eligible HCF members with hospital cover.

Smokers are also at a higher risk of complications following surgery, so this could be a good time to quit. 

Consultation with the anaesthetist

Your anaesthetist will explain the options and risks of anaesthesia. They’ll want to know about any other existing medical conditions you may have, especially conditions such as lung or heart disease, kidney problems or previous problems with anaesthesia.

Your anaesthetic options

The types of anaesthetic you may be offered.


Information is provided by HCF in good faith for the convenience of members. It is not an endorsement or recommendation of any form of treatment nor is it a substitute for medical advice, and you should rely on the advice of your treating doctors in relation to all matters concerning your health. Every effort has been taken to ensure the accuracy of the information, however HCF takes no responsibility for any injury, loss, damage or other consequences of the use of this information.