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A permanent pacemaker is a heart rhythm device implanted through a minor surgery. 

You're usually a candidate for a pacemaker if you have an abnormally slow heart rate with these symptoms:

  • Fatigue
  • Shortness of breath
  • Lightheadedness
  • Passing out

An abnormally slow heart rate can come from the failure of the heart's sinus node (its natural pacemaker). The sinus node sends electrical signals at the appropriate times or problems with transmission of electrical signals through other parts of the electrical system.

Benefits of Pacemakers

Pam Mason, MD, discusses the benefits of pacemakers. View pacemakers transcript.

How We Implant a Pacemaker

  • Your doctor implants a pacemaker under the skin in the upper portion of the chest near the left shoulder. 
  • Prior to the procedure, your doctor sterilizes the area to help minimize infection. 
  • You're sedated and generally sleep through the procedure. 
  • Local anesthetic is used to numb the skin below the collarbone and a small incision is made (about 1.5 inches long). 
  • A space is created beneath the skin for the pacemaker, which is roughly the size of a half-dollar. 
  • Next, one or more wires, or leads, are inserted into a vein beneath the collarbone. This vein connects with the heart and allows the wire(s) to be passed into the heart. 
  • The wires allow the pacemaker to monitor the heart’s electrical system and stimulate the heart (or speed it up) if the heart rate becomes too slow. 
  • The wires are then connected to the pacemaker, which is then placed under the skin. 
  • Your doctor closes the incision with sutures and/or staples. 
  • After we insert your pacemaker, you'll have to stay overnight for monitoring. 
  • The following day we'll take an X-ray of your chest. 
  • You're generally discharged the day after the procedure.


Your doctor may give you a list of restrictions after you've received a pacemaker, including:

  • Temporarily no reaching overhead with the arm on the same side as the pacemaker
  • Keeping the incision dry for 48 hours 
  • Avoiding heavy lifting for two months

We ask you to return to the clinic two weeks after pacemaker placement so we can check the incision and the pacemaker. After that, we usually check the device every three months, either in the clinic or remotely by telephone or internet.