Permanent Pacemaker Implantation
A permanent pacemaker is for a heart whose own electrical system can no longer be relied on. A device about the size of a matchbox sits under the skin below the collarbone, with one or two wires running through a vein into the heart. It watches every beat and steps in only when one is missed.
- Device under the skin, wires through a vein
- Awake, under local anaesthetic
- Home within a day or two
- Battery lasts around eight to twelve years
Stay
1 to 2 days
Duration
About 1 to 2 hours
Anaesthesia
Local, with sedation
About Permanent Pacemaker Implantation
The pacemaker monitors your heart continuously and paces only when the rate falls below a set threshold. Most people are unaware of it working. The device is implanted through a small incision below the collarbone, and the wires are guided into the heart through a vein using X-ray screening. It is checked at intervals in clinic, where the settings can be adjusted without another procedure.
- Paces only when a beat is missed
- Checked in clinic, adjusted without surgery
- Battery replacement is a smaller procedure than the first implant
- Most daily activities and appliances are unaffected
Before you read on
Everything here is general information about permanent pacemaker implantation. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest permanent pacemaker implantation.
- Persistently slow heart rate causing tiredness, dizziness or blackouts
- Complete or high-grade heart block
- Sick sinus syndrome
- Pauses in the heart rhythm found on a monitor
- Slow rhythm that did not recover after temporary pacing
Procedure details
The usual sequence, from first consultation through to follow-up.
Assessment and consent
An ECG, monitoring and blood tests confirm the diagnosis, and the type of pacemaker is chosen and explained to you.
Making the pocket
The skin below the collarbone is numbed and a small pocket is created under it for the device.
Positioning the wires
One or two wires are passed through a vein into the heart under X-ray guidance and tested to confirm they are in the right place.
Connecting and closing
The wires are attached to the device, it is settled into the pocket and the incision closed. The device is tested before you leave the room.
How to prepare
What to sort out before you come in.
- Blood tests, an ECG and a chest X-ray are done beforehand
- You will be asked not to eat for several hours before the procedure
- Blood thinners may need adjusting, so tell the team what you take
- Have a shower and do not apply cream to the chest that morning
- Arrange somebody to take you home and help for the first few days
Recovery
What to expect afterwards, and roughly when.
- Most people go home the day after implantation
- Keep the wound dry and do not raise that arm above shoulder height for a few weeks
- Avoid heavy lifting on that side for about six weeks so the wires settle
- Mild bruising and a feeling of the device under the skin are normal
- The first device check is usually within a few weeks, then at regular intervals
Why choose Humayun for pacemaker implantation
A pacemaker is a device you live with for a decade, so the follow-up matters as much as the implant.
- Implanted in a cath lab rather than a general theatre, with screening throughout
- Device checks and reprogramming done here rather than at another centre
- The cardiologist who implants it is the one who follows it up
- Emergency and temporary pacing available in the same unit if the rhythm deteriorates first
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