Pacemaker Placement
Pacemaker placement is a medical procedure used to implant a small electronic device under the skin of the chest to help regulate the heartbeat. The pacemaker consists of a battery-powered generator and one or more leads (wires) that connect to the heart. It is typically placed in a pocket beneath the skin near the collarbone, on either side of the chest.
In a healthy heart, electrical signals control the heart’s rhythm, ensuring it beats regularly and pumps blood efficiently. When this system doesn’t function properly—causing the heart to beat too slowly or irregularly—a pacemaker can help by sending electrical impulses to maintain a normal heart rate.
What does it do?
A pacemaker is designed to treat certain heart rhythm disorders such as bradycardia (slow heart rate), arrhythmias, or in some cases, atrial fibrillation. It constantly monitors your heartbeat and only activates when it detects an abnormal rhythm.
If your heart skips a beat or beats too slowly, the pacemaker sends a mild electrical signal to correct it. When your heart is beating normally, the device remains inactive. Pacemakers help prevent symptoms like dizziness, fatigue, or fainting and ensure the heart maintains a safe and effective rhythm.
How does it work?
Pacemakers help restore a regular heartbeat by supporting or replacing the heart’s natural electrical system. They are commonly used and can last up to 10–15 years, depending on the type.
There are several types of pacemakers:
- Leadless Pacemaker – A compact, self-contained unit implanted directly into the heart without wires
- Single-Chamber Pacemaker – Connects to one chamber of the heart
- Dual-Chamber Pacemaker – Connects to two chambers (usually one atrium and one ventricle)
Bi-ventricular Pacemaker – Used in heart failure patients to synchronize both sides of the heart (also called cardiac resynchronization therapy)
Why is it performed?
Pacemaker placement is recommended when the heart is unable to maintain a healthy rhythm on its own. This may result in insufficient blood flow, leading to symptoms such as fatigue, dizziness, or fainting. Some common causes include:
- Natural aging of the heart’s electrical system
- Damage from a previous heart attack
- Complications after heart surgery
- Viral infections affecting the heart
Genetic or inherited conduction disorders
The procedure
Pacemaker insertion is considered a minor surgical procedure and typically takes 1–2 hours under local anaesthetic and light sedation:
- A small incision is made near the collarbone to create a pocket under the skin.
- The pacemaker leads are inserted through a nearby vein and guided into the heart.
- Once in place, the leads are secured and connected to the battery unit.
- The pacemaker is programmed to match your heart’s specific rhythm needs.
- The pocket is closed with stitches, and the site is dressed.
The battery unit may be visible as a small bump under the skin, but it is not usually painful or uncomfortable once healed.
Recovery
After the procedure:
- You’ll be taken to the ward to rest and be monitored.
- Some bruising or mild discomfort around the incision site is normal and should resolve in a few weeks.
- You’ll receive detailed instructions on activity restrictions, wound care, and how to manage your pacemaker at home.
- Follow-up appointments will be scheduled to monitor pacemaker function and healing.
Most people can resume normal daily activities within a few days, with some limitations on lifting and shoulder movement in the initial weeks.