Illnesses & Conditions
Information on diseases and health concerns, including symptoms, treatment options, and prevention.

Pacemaker placement

Surgery Overview

A pacemaker can be used to replace the function of the natural pacemaker of the heart when the heart is beating too slowly.

A pacemaker is a small, battery-powered device that sends out weak electrical impulses that cause the heart muscle to contract. The pacemaker itself is a waterproof object about the size of a silver dollar. A pacemaker consists of wires (leads), which transmit electricity to the heart, and the pulse generator and battery, which generate the electrical impulses.

See a picture of a pacemaker .

Pacemakers can be surgically placed into the chest (a permanent pacemaker) through a small incision, or they can be worn outside the body (a temporary pacemaker) and attached to the heart through a wire that is threaded through a neck vein. Temporary pacemakers are used only while a person is in the hospital.

There are several types of permanent pacemakers.

• A fixed-rate pacemaker gives off electrical impulses at a steady, regular rate, regardless of your level of activity.
• A rate-responsive pacemaker changes the rate of electrical impulses as your activity level changes.
• A single-chamber pacemaker controls only the lower chamber of the heart (ventricle).
• A dual-chamber pacemaker controls both the top (atrium) and bottom (ventricle) chambers of the heart.

Many times the pacemaker is set to work only when the heart rate falls below a certain predetermined rate (demand mode).

The battery in a permanent pacemaker usually lasts 5 to 15 years. Your doctor will monitor your pacemaker regularly to decide when the battery should be changed.

The surgery needed to implant a permanent pacemaker is considered a minor surgical procedure. It can usually be done using local anesthesia, which means part of your body is numbed, but you stay awake.

A small incision is made in the chest wall. The pacemaker leads are usually threaded through the incision into a large blood vessel in the upper chest and into the heart. Using the same incision, a small pocket is created under the skin to hold the pulse generator. The leads are then hooked up to the pulse generator. The entire procedure usually takes about 1 hour.

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