A pacemaker is a small device that helps your heart beat properly. It is implanted in your chest and connected to a spot inside your heart with special wires called leads.

A very small pulse of electricity is transmitted from the device, along the leads directly into the heart muscle. This electrical current makes the heart beat and can be delivered as needed to keep your heart beating at a healthy rate.

Arrhythmias are abnormalities of the heart’s electrical system that disrupt the normal heartbeat. Tachycardia occurs when the heart beats too rapidly. Bradycardia occurs when the heart beats too slowly.

Arrhythmias are very common and usually do not cause problems; but in rare cases, they can cause you to have symptoms such as dizziness or extreme tiredness.

Most patients need a pacemaker because their hearts beat too slowly to meet the needs of their bodies. This is known as bradycardia. A slow heart rate can cause symptoms such as dizziness, fatigue or fainting spells that can put you at risk of injury or harm.

In general, pacemakers have two basic parts: the pacemaker generator (sometimes called the battery) and one or more wires called leads.

The generator contains the battery, important wiring and computer components that make the pacemaker work properly. The leads are special wires that connect the generator to a spot inside your heart.


Getting a pacemaker implant is usually a day procedure. This means you should expect to be at the Heart Institute for 8 to 12 hours.

  1. Before you go for your implant, the doctor will come and meet you in the Day Unit. This will be a good time to ask any questions you may have.
  2. Once you are in the Day Unit, the final preparations for your procedure will start. You will change into a hospital gown. You may have a small intravenous tube placed in your arm. The implant area will be clipped of hair and cleaned.
  3. The actual pacemaker implant procedure will take place in a room called the Electrophysiology Lab. There will be a team of doctors, nurses and lab technologists involved in your procedure. All staff will be wearing gowns, masks and special lead aprons.
  4. Your chest area will be washed with a cold solution, and sterile sheets will be placed over you. It is important that you don’t move or touch the top of the sheets once they are in place. A nurse will be available to assist you if you have any concerns during your procedure.
  5. During your procedure, you will receive medications in your intravenous that will make you feel very relaxed. You might even fall into a light sleep. Additionally, to make sure you stay comfortable, you will receive pain medications in your intravenous, as needed.
  6. A local anesthetic will be administered to the area below your collarbone to numb the area where the pacemaker will be inserted.
  7. Once the anesthetic has taken effect, the doctor will make a small incision. Using a special X-ray, the pacemaker leads will be threaded in to your heart through a vein in your chest. You will not feel any pain, but you may feel some pressure as the vein is entered. The generator is then put into place just under the skin. Tell the nurse immediately if you feel any discomfort or have any concerns. It is very important you remain as still as possible during the procedure.
  8. Once the procedure is finished, the incision will be closed with special stitches. You will not need to have them removed. They will dissolve on their own. If you are having a standard pacemaker implant, the whole procedure will probably take 1 to 2 hours to complete. If you are having a CRT- pacemaker, the procedure will take 2 to 4 hours.

After Your Procedure

  1. After your procedure, you will be taken back to the Day Unit on a stretcher or bed. You may be hooked up to a heart monitor that will keep track of your heart rate and your blood pressure. Shortly after your procedure, you will go for a chest X-ray to check your pacemaker placement.
  2. You may eat and drink as normal when you return to the Day Unit. Your nurse will assess and assist you as necessary. If you are feeling okay, the nurse will bring you a light snack and something to drink.
  3. Once you are feeling better, you will be able to go home.

Patient instructions

  • Only one friend or relative will be able to sit with you while you are waiting because space is limited.
  • You must have someone pick you up at the hospital and drive you home.