Pacemaker Implantation: How is it done?

When we're ready to start you'll be brought into the cardiac catheterization lab (much like an operating room with x-ray cameras) and you'll lie on a table while our technicians prepare the area on your body where we'll be working. In most patients we place the pacemaker just below the collarbone on the left chest wall. We can also implant the pacemaker on the right if there is a reason the left side can't be used (e.g. a patient with a left arm dialysis fistula or previous surgery for breast cancer). The technicians will cover your chest and face with a drape to protect the sterile area where we'll work (the drape over the face can bother some patients—we can provide more sedation to you if you think this will be a problem). After providing you with some sedating medication we numb the area of skin with local anesthetic. We make an incision about an inch and a half long and then create an area under the skin where we can place the pacemaker. We pass the wires (leads) into a vein which leads directly into the right atrium and ventricle of the heart. Once we place and secure the leads in the heart we test them electrically to make sure we have good conduction and adequate position to pace the heart. We attach the leads to the pacemaker and place it under the skin. We close the skin with absorbable suture so that you will not need stitches removed. You will stay in the hospital overnight so that we can observe your heart rhythm and check the status of your pacemaker and leads in the morning. There is a small chance that one of the leads will pull free from where we put it within the first few hours after surgery. We are able to easily detect this on the morning after surgery and return to the cath lab to fix it if necessary.

If all goes well you are discharged from the hospital on the day after surgery.

Related Links:

Joseph Thibodeau, M.D.
http://www.alegent.com/Thibodeau

Alegent Health Heart & Vascular Specialists
http://www.alegent.com/heartandvascular

Cardiology Blog
http://www.alegent.com/heartblog

Alegent Health Podcast #27
Heart Palpitations
http://www.alegent.com/podcast27

Alegent Health Clinic
http://www.alegent.com/clinic

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Science & Technology

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