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How is a pacemaker implanted?

Omid Hajiseyed Javadi, MD
Thoracic Surgery (Cardiothoracic Vascular)
Knowing what to expect can ease worries if you or a loved one is having a pacemaker implanted. But as thoracic surgeon Omid Javadi, MD, of Good Samaritan Hospital, explains in this video, the procedure is fairly simple.  
Pacemakers usually are located in the area below the left collarbone. Typically, they feel like a small lump under the skin.
Implantation of a pacemaker -- a device used to regulate your heart rhythm -- requires a surgical procedure that is generally performed by an electrophysiologist, who is a specialized cardiologist or a surgeon. A small incision (2-3 inches) is made under your collarbone either on the right or left side of your chest. Depending on the type of pacemaker system you need, either one of two leads will be placed through a large vein under your collarbone and threaded down the inside of your heart. The physician implanting your device uses a special type of x-ray (fluoroscopy) to position the leads inside your heart. The leads are attached to the inner surface of the heart muscle by either a small corkscrew (active fixation) or a tined tip (passive fixation). Electrical measurements of the lead(s) position are performed to ensure a proper location and fixation.

Once the lead(s) are positioned inside your heart muscle, the physician will then create a small pocket or space to fit the pulse generator under the skin of your chest. The lead(s) are then plugged in to the pulse generator and firmly tightened in place. The pulse generator is then placed in to the pocket and the skin is sutured (sewn) back together. A dressing is placed over the operative site to keep it clean. As with most surgical procedures, antibiotics are generally given before and after your pacemaker implantation to decrease the likelihood of infection.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.