A permanent pacemaker is a battery-operated device that assists the heart by delivering small electrical impulses that set pace for the heart when it beats too slowly. It consists of a “can” or “generator” that houses the battery and electronic circuitry and one or more “leads” or insulated wires that enter the heart and make contact with the heart tissue. The pacemaker generator is typically the size of a half-dollar coin and is about two or three coins thick, depending on the manufacturer.

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Insertion of a permanent pacemaker is performed in the cardiac catheterization lab or the operating room. It usually involves local anesthesia with conscious sedation (like that for a colonoscopy). Your doctor makes a small incision below the collar bone and places wires into a large vein of the chest leading into the heart. These are then attached to the generator and placed under the skin. The procedure lasts 1-2 hours and you will generally be able to go home after an overnight stay in the hospital.

The computer circuitry of the pacemaker requires routine scheduled interrogations to check battery status and other device functions which are done in your doctor’s office and wirelessly from home for the life of the pacemaker. This is typically 5-10 years until the battery is depleted at which time a repeat minor procedure is necessary to replace the pacemaker generator.

The risks associated with the procedure are generally minor. They can include mild pain, bleeding, bruising, or temporary swelling of the arm on the side of the procedure. Other complications are less common and include infection, injury to the heart and lungs, or problems with the device itself that may require another procedure to fix. Major complications occur about 1% of the time and the majority of people do not have long-term problems with their pacemaker.

For more information, please see: www.cardiosmart.org