Cardiology · Electrophysiology & Devices
Pacemaker Implantation
A safety net for a slow heart
Medically reviewed by Dr Kunal Ajay Patankar, DrNB (Cardiology)
What it is
A pacemaker is a small device — the size of a matchbox, or a large vitamin capsule for leadless models — that monitors every heartbeat and steps in only when the heart's own rhythm is too slow or pauses.
Implanted under the skin below the collarbone through a small incision, modern pacemakers last 10–15 years, are MRI-compatible, and can be checked remotely.
Who needs it
- Blackouts or giddiness from a slow heart rate (bradycardia)
- Heart block — the electrical signal failing to reach the pumping chambers
- Pauses in heart rhythm on Holter monitoring
- Certain rhythm conditions after heart attack or valve procedures
How it happens, step by step
1
Local anaesthesia
The area below the collarbone is numbed; you remain awake and comfortable throughout the 45–90 minute procedure.
2
Lead placement
One or two soft insulated wires are guided through a vein into the heart and tested for perfect electrical contact.
3
Device pocket
The pacemaker generator is placed in a small pocket under the skin and connected to the leads.
4
Programming
The device is programmed wirelessly to your specific rhythm problem before you leave the lab.
Recovery, honestly
- Usually home the next day
- Keep the arm on the implant side below shoulder level for 2–3 weeks
- The scar fades to a thin line; the device outline is barely noticeable
- Device checks every 6–12 months, many done remotely
Common questions
Can I use a mobile phone or microwave?
Yes. Everyday electronics are safe. Keep mobile phones about 15 cm from the device (use the opposite ear) and avoid placing them in a pocket directly over it.
Will I feel it pacing?
Almost never. The impulses are tiny. Most patients simply notice their giddiness and blackouts are gone.
What happens when the battery runs low?
Routine checks predict this years ahead. Replacing the generator is a simpler, shorter procedure using the same pocket and leads.
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