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Pacemaker Insertion

A pacemaker is a small device with one to three leads attached to various chambers of the heart which sends out an electrical impulse the stimulate the heart to contract. These devices are implanted when your hearts own natural pacemaker—the sino-atrial node or the heart electrical conduction pathways have a problem.

The procedure entails inserting the leads (how many you need depends on your condition) into the heart and attaching them to the pacemaker box (a small metal device a little bigger than a plastic milk bottle top) which is placed under the skin just under your collar bone near your armpit.

For this procedure you are moved from your bed to the X-ray table and connected to an ECG to monitor your heart. A probe is also placed on your finger (or toe) to monitor your breathing. The area around your shoulder and chest is washed with antiseptic solution and a big blue drape is placed over you from head to foot. There is a small window for your face.

Your doctor will inject some local anaesthetic in the area under your collar bone. The pacemaker leads are introduced into the subclavian vein and then moved towards your heart using the X-rays to see where they are going. Where each lead goes depends on your doctor and your condition.

Once the leads are in place a pocket is made under the skin for the pacemaker box to fit into. The leads are connected to the box and all is stitched into place and the pacemaker begins to work as it has been programmed.

A dressing is applied over your wound and you will be instructed not to move your arm above shoulder height for a day so you don’t dislodge the lead(s). Your pacemaker will be checked the following morning.