Pacemaker Implantation
A pacemaker is a small battery-powered device implanted under the skin below the collarbone to regulate the heart's electrical impulses. It continuously monitors the heart rate and delivers electrical pulses to stimulate the heart to beat when it is too slow (bradycardia) or pauses. Modern pacemakers have dual-chamber and rate-responsive capabilities and communicate wirelessly with programmers for adjustment without surgery. Iswarya Hospital's cardiac team implants single-chamber, dual-chamber, and biventricular (CRT) pacemakers.
🔬 How the Procedure Is Performed
- 1
Local anaesthesia is injected below the left collarbone; mild sedation is given.
- 2
A small incision is made in the skin; a pocket is created under the skin/muscle.
- 3
One or two leads (wires) are passed through a vein into the heart chambers.
- 4
The leads are tested to confirm correct placement and sensitivity.
- 5
The pulse generator (battery and computer) is connected and placed in the pocket.
- 6
The skin is sutured; a chest X-ray confirms correct lead position.
✅ Benefits of Pacemaker Implantation
- ✓Immediately corrects life-threatening slow heart rates
- ✓Prevents blackouts (syncope) and sudden cardiac death from bradycardia
- ✓Virtually painless, minimally invasive procedure
- ✓Modern devices last 8–15 years before battery replacement is needed
- ✓Remote monitoring allows the cardiologist to check the device without a hospital visit
📋 How to Prepare
- ECG, 24-hour Holter monitor, and echocardiogram to confirm the need for pacing.
- Fast for 6 hours before the procedure.
- Stop blood thinners as directed — aspirin may be continued.
- Blood tests and chest X-ray.
- Arrange for someone to collect you — same-day discharge or one overnight stay.
⚠️ Possible Risks & Side Effects
- Lead displacement — may require repositioning within the first few days
- Infection of the device pocket — managed with antibiotics or device removal
- Pneumothorax (collapsed lung) from lead insertion — rare
- Haematoma (blood collection) at the implant site
- Twiddler's syndrome — patient manipulates the device, dislodging leads (rare)
Your surgeon will discuss all risks with you before the procedure and take appropriate precautions to minimise them.
💊 Post-Procedure Care
- Do not lift the arm on the pacemaker side above shoulder level for 4–6 weeks.
- Keep the implant site clean and dry.
- Carry the pacemaker identification card at all times.
- Inform all doctors and dentists about the pacemaker before any procedure.
- Avoid MRI scans (modern MRI-conditional pacemakers have specific protocols).
❓ Frequently Asked Questions
Can I use a mobile phone with a pacemaker?
Yes. Modern pacemakers are well shielded. Keep your phone 15 cm away from the device (don't carry it in the breast pocket on the pacemaker side), but normal use is safe.
Will the pacemaker be visible under the skin?
A small raised area may be visible under thin skin, but it is generally not very noticeable. The device sits in a pocket below the collarbone, covered by skin and a thin layer of tissue.
How long does the battery last?
Most pacemakers last 8–15 years depending on how often pacing is delivered. When the battery runs low, only the generator is replaced — the leads are usually reused.
🏥 Pacemaker Implantation at Iswarya Hospital
Complete spectrum of cardiac services including non-invasive cardiology, interventional cardiology, electrophysiology, cardiac surgery, and cardiac rehabilitation. Emergency angioplasty available 24×7.
ℹ️ This information is for educational purposes only and does not constitute medical advice. Individual treatment plans may vary. Always consult a qualified healthcare professional before making any medical decisions.