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A pacemaker insertion is the implantation of a small electronic device that is usually placed in the chest (just below the collarbone) to help regulate slow electrical problems with the heart. A pacemaker may be recommended to ensure that the heartbeat does not slow to a dangerously low rate.

The pacemaker sends electrical pulses to your heart to keep it beating regularly and not too slowly.

Having a pacemaker can significantly improve your quality of life if you have problems with a slow heart rate. The device can be lifesaving for some people.

Types of pacemakers

Your doctor will decide what type of pacemaker you need based on your heart condition. Your doctor also determines the minimum rate (lowest heart rate) to set your pacemaker.

  • Leadless Pacemaker – Self-contained device without connecting leads (wires) and generator
  • Biventricular Pacemaker – also called cardiac resynchronization therapy (CRT)
Why do I need a pacemaker?

The heart is essentially a pump made of muscle, which is controlled by electrical signals.

These signals can become disrupted for several reasons, which can lead to a number of potentially dangerous heart conditions, such as:

  • an abnormally slow heartbeat (bradycardia)
  • an abnormally fast heartbeat (tachycardia)
  • heart block (where your heart beats irregularly because the electrical signals that control your heartbeat aren’t transmitted properly)
  • cardiac arrest (when a problem with the heart’s electrical signals cause the heart to stop beating altogether)
How is a pacemaker fitted?

Having a pacemaker implanted is a relatively straightforward process.

  • It’s usually carried out under local anaesthetic, which means you’ll be awake during the procedure.
  • The generator is usually placed under the skin near the collarbone on the left side of the chest.
  • The generator is attached to a wire that’s guided through a blood vessel to the heart.
  • The procedure usually takes about an hour, and most people are able to leave hospital on the same day or a day after surgery.
What are the risks of the procedure?

Possible risks of pacemaker include, but are not limited to, the following:

  • Bleeding from the incision or catheter insertion site
  • Damage to the vessel at the catheter insertion site
  • Infection of the incision or catheter site
  • Pneumothorax. If the nearby lung is inadvertently punctured during the procedure, leaking air becomes trapped in the pleural space (outside the lung but within the chest wall); this can cause breathing difficulties and in extreme cases may cause the lung to collapse.

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