A pacemaker implantation is a medical procedure in which a small electronic device called a pacemaker is surgically implanted under the skin, typically in the chest just below the collarbone. This device helps regulate and control abnormal or slow heart rhythms by sending electrical impulses to the heart when needed.

  • A pacemaker is a device composed of a pulse generator and one or more leads with electrodes.
  • It is used to treat various heart rhythm disorders, such as bradycardia (slow heart rate) or tachy-brady syndrome (alternating fast and slow heartbeats).
  • Pacemaker insertion is performed to ensure that the heart maintains a healthy and consistent rhythm.


  • The primary purpose of a pacemaker is to regulate and control the heart's electrical impulses.
  • It helps maintain a normal heart rate, preventing the heart from beating too slowly or irregularly.
  • Pacemakers can improve the quality of life for individuals experiencing symptoms like fatigue, dizziness, fainting, and chest pain due to heart rhythm issues.


  • Before the procedure, the patient will be informed about the surgery and asked to sign a consent form.
  • The patient may need to fast for a certain period before the surgery, usually overnight.
  • Allergies, medications, and medical history will be discussed with the healthcare physician.
  • Blood tests may be performed to assess clotting ability.
  • The patient may receive a sedative to help with relaxation.
  • In some cases, patients may need to discontinue specific medications that affect blood clotting before the procedure.

During the Procedure

  • The patient is prepared for the procedure by removing any jewelry or objects that could interfere.
  • They change into a hospital gown and receive an intravenous (IV) line for medications and fluids.
  • Electrocardiogram (ECG) electrodes are placed on the chest to monitor heart activity.
  • Large electrode pads are applied to the chest for additional monitoring.
  • The insertion site is cleansed with antiseptic soap, and the area is draped with sterile towels.
  • Local anesthetic is injected into the skin at the insertion site to numb the area.
  • Once the anesthetic takes effect, a small incision is made near the collarbone.
  • A sheath (introducer) is inserted into a blood vessel, usually under the collarbone.
  • One or more lead wires with electrodes are threaded through the sheath and advanced into the heart.
  • The leads are carefully positioned within the heart chambers and tested for proper function.
  • The pacemaker generator, containing the battery and circuitry, is placed under the skin through the incision.
  • Leads are attached to the generator, and the incision is closed with sutures, adhesive strips, or glue.
  • Sterile bandages or dressings are applied over the incision site.
  • The pacemaker is tested to ensure it functions correctly.

After the Procedure

  • The patient is monitored in the recovery room for a period to ensure stability.
  • They may receive pain medication if needed and be allowed to eat or drink.
  • The incision site may be sore, and pain management measures are provided.
  • A follow-up appointment will be scheduled to review the pacemaker's activity and adjust settings as necessary.
  • In some cases, patients may stay overnight in the hospital for observation.