Pacemaker Implantation


What is a pacemaker?

A pacemaker is a device that is inserted under a patient’s skin, usually near the left shoulder. A pacemaker has two components: a generator and leads. The leads are placed into a patient’s heart by entering through a vein near the shoulder. The leads are connected to a generator which is similar to a small computer.


Who should receive a pacemaker?

Pacemakers are recommended for patients who feel poorly as a result of bradycardia or slow heart rates. Patients who experience lightheadedness, syncope, or fatigue from slow heart rates will frequently feel better after a pacemaker is implanted.


How does a pacemaker work?

The pacemaker monitors a person’s heart rate. When a patient’s heart rate becomes too slow, the pacemaker delivers a signal to the heart to beat so that the person’s heart rate becomes more normal.


What can I expect at the time of pacemaker implantation?

A pacemaker is implanted by making a small incision usually near the left shoulder. A needle is inserted into a vein, wires are placed through the needles, and leads are placed through that entry down to the heart. The generator is attached to the leads and placed in a small "pocket" under the skin. The procedure takes 1-2 hours. Patients usually remain overnight in the hospital for observation and go home the next morning. The main risk of the procedure is bleeding or infection which can occur about 1% of the time. Other risks are rare although they may be more serious.

After implantation, we recommend that patients keep the dressing on for 5 days. Patients should avoid taking a shower for 3 days. After 3 days, the dressing may get wet. Patients are also instructed to avoid lifting their arm over their shoulder for 6 weeks to avoid dislodging the lead.