Pacemaker Implantation (Single and Dual Chamber)
A small device placed under the skin below the collarbone that keeps the heart from beating too slowly, often relieving dizziness, fainting and tiredness.
What a pacemaker does
A pacemaker is a small battery-powered device that watches your heartbeat. When the heart beats too slowly or pauses, it sends a tiny electrical signal that makes the heart beat. Most of the time you do not feel it working.
Who may need one
The usual reason is a slow heartbeat or heart block that causes symptoms such as dizziness, fainting, unusual tiredness or breathlessness. The decision is based on ECGs, Holter monitoring and your symptoms. Some medicines can slow the heart too, so your doctor will review them first.
Single or dual chamber?
- Single chamber: one lead, usually placed in the lower right chamber (ventricle).
- Dual chamber: two leads, one in the upper chamber (atrium) and one in the lower chamber, so the two work in a more natural sequence.
Your cardiologist chooses the type based on your rhythm problem.
How it is implanted
- The area below the collarbone, usually on the left, is numbed with local anaesthesia. A mild sedative may be given.
- A small cut is made and the leads are passed through a vein into the heart under X-ray guidance.
- The leads are tested and connected to the pacemaker, which is placed in a small pocket under the skin.
- The wound is closed and dressed.
Living with a pacemaker
- Keep the wound clean and dry until it heals. Avoid lifting the arm on that side above shoulder level and heavy lifting for the first few weeks, as advised.
- Carry your device card. Show it at airport security.
- Keep your mobile phone about 15 cm away from the device; do not keep it in a pocket over it.
- Tell any doctor about the pacemaker before an MRI or surgery.
- Regular device checks are needed. When the battery runs low after several years, the pacemaker box is replaced in a smaller procedure.
When to call
Call if the wound becomes red, swollen, hot or leaks fluid, if you develop fever, or if dizziness or fainting returns. A related device, the ICD, is used for dangerously fast rhythms; your heart's pumping is often checked with echocardiography.
Whether you need a pacemaker, and which type, is decided only after examination and your reports. This page is for understanding, not a substitute for consultation.
For understanding only — the right test or treatment is decided after examination.
