Pacemaker Implantation

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A pacemaker is a small device that’s placed (implanted) in the chest to help control the heartbeat. It’s used to prevent the heart from beating too slowly. Implanting a pacemaker in the chest requires a surgical procedure.

A pacemaker is also called a cardiac pacing device.

Why it's done

A pacemaker is implanted to help control your heartbeat. Your doctor may recommend a temporary pacemaker when you have a slow heartbeat (bradycardia) after a heart attack, surgery or medication overdose but your heartbeat is otherwise expected to recover. A pacemaker may be implanted permanently to correct a chronic slow or irregular heartbeat or to help treat heart failure.

What a pacemaker does

Pacemakers work only when needed. If your heartbeat is too slow (bradycardia), the pacemaker sends electrical signals to your heart to correct the beat. Some newer pacemakers also have sensors that detect body motion or breathing rate and signal the devices to increase heart rate during exercise, as needed.

A pacemaker has two parts:

Pulse generator: This small metal container houses a battery and the electrical circuitry that controls the rate of electrical pulses sent to the heart.
Leads (electrodes): One to three flexible, insulated wires are each placed in one or more chambers of the heart and deliver the electrical pulses to adjust the heart rate. However, some newer pacemakers don’t require leads. These devices, called leadless pacemakers, are implanted directly into the heart muscle.

Types

Depending on your condition, you might have one of the following types of pacemakers.

Single chamber pacemaker. This type usually carries electrical impulses to the right ventricle of your heart.
Dual chamber pacemaker. This type carries electrical impulses to the right ventricle and the right atrium of your heart to help control the timing of contractions between the two chambers.
Biventricular pacemaker. Biventricular pacing, also called cardiac resynchronization therapy, is for people who have heart failure and heartbeat problems. This type of pacemaker stimulates both of the lower heart chambers (the right and left ventricles) to make the heart beat more efficiently.

Risks

Complications related to pacemaker surgery or having a pacemaker are uncommon, but could include:

Infection near the site in the heart where the device is implanted
Swelling, bruising or bleeding at the pacemaker site, especially if you take blood thinners
Blood clots (thromboembolism) near the pacemaker site
Damage to blood vessels or nerves near the pacemaker
Collapsed lung (pneumothorax)
Blood in the space between the lung and chest wall (hemothorax)
Movement (shifting) of the device or leads, which could lead to cardiac perforation (rare)