Pacemaker Implantation

You are awake but sedated. The area is numbed thoroughly, so what you feel is pressure and tugging rather than pain, and the sedation blurs most of it. It usually takes about an hour. General anaesthesia is not normally needed, which is part of why you can go home the next day.

No, and it is worth hearing this plainly. A pacemaker treats one thing: a heart that beats too slowly. It does not strengthen a weak pump, does not unblock an artery, does not prevent a heart attack or a stroke, and does not cure atrial fibrillation. If breathlessness is coming from a weak heart rather than a slow one, a pacemaker will not fix it. Your medicines and the rest of your heart care continue exactly as before.

Almost never. The impulses are far too small to feel. What people usually notice is the absence of something — the blackouts stop, the dizziness goes, stairs become possible again. Between beats it makes no sensation at all. A few people feel occasional hiccup-like twitching if a lead sits near the diaphragm, and that is corrected by reprogramming.

Yes to all three, with small precautions. Use the phone at the ear opposite the device and keep it out of a breast pocket over it. Stand an arm's length from an induction hob rather than leaning across it. Microwaves, televisions, computers and household appliances are entirely safe. At the airport, show your device card, walk through steadily without lingering, and ask for a hand search rather than a hand-held wand held over the device. Arc welding, industrial magnets and high-power electrical equipment are the genuine ones to avoid.

Usually yes. Most devices and leads implanted today are MRI-conditional, meaning a scan can be done safely under defined conditions — the device reprogrammed beforehand and monitored during the scan. Tell every radiology department that you have a pacemaker and bring your card; never assume they already know. If you have older leads, we will tell you plainly what is and is not possible.

Commonly ten to fifteen years, and longer if your own rhythm does most of the work and the device rarely paces. It never simply runs out without warning — routine checks track the level and predict it months to years ahead. When the time comes, the generator is replaced through the same pocket in a shorter, simpler procedure, and healthy leads are left exactly where they are.

Driving on an ordinary licence usually resumes after about a week, and we give you a date; commercial and heavy-vehicle licensing has its own rules that we will go through with you. Lifting and overhead work wait four to six weeks, until the leads have anchored. After that, walking, swimming, gym work and ordinary sport are actively encouraged. Contact sports and heavy overhead work on the device side are what we discuss case by case.

In a slim person a small outline is visible below the collarbone; in most people it is noticeable only if you look for it. The scar fades to a thin line. Once healing is complete you can sleep on either side — you will not damage it, and most people find their own comfortable position within a few weeks. If it sits somewhere that rubs against a bra strap or a seatbelt, tell us before the implant, because the placement can be adjusted.

Age by itself is rarely the deciding factor here, and this is where a pacemaker differs from most heart procedures. It is a short implant under local anaesthesia that stops blackouts and falls — and in an older person, a fall is often the thing that changes life most. Pacemakers are routinely implanted in people in their eighties and nineties. What we weigh is not your age but whether the slow rhythm is genuinely what is limiting you.

There is no tablet that reliably speeds up a slow heart over the long term. Medicines can lift the rate briefly in an emergency, and stopping a rate-slowing drug sometimes solves the problem entirely — which is exactly why we review your prescriptions before recommending a device. But where the heart's own wiring has failed, a pacemaker is the only treatment that works, and no medicine substitutes for it.

Some people are pacemaker-dependent, meaning their own rhythm is too slow to manage without it, and many are not — the device simply covers the gaps. Outright failure is very rare, and devices are built to fail safe: batteries deplete slowly and predictably rather than stopping, and checks catch a lead problem long before you feel anything. If you are dependent, we tell you so, and your follow-up is arranged accordingly.

By your rhythm, not by preference. If the atria are in permanent atrial fibrillation there is nothing useful for an atrial lead to do, so a single-chamber device is the right answer. If the atria still beat normally, a dual-chamber device keeps the top and bottom chambers working in the correct order, which most people feel. A leadless device suits someone in whom a pocket or a vein is the problem — poor veins, high infection risk, or a need to keep the chest wall clear. We explain which of these applies to you and why.