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Pacemakers

A pacemaker is a small battery-powered device that is permanently implanted under your skin. The device is most often implanted in the shoulder area just under the collarbone. It sends electrical signals to start or regulate a slow or irregular heartbeat.

The specialists at UPMC perform hundreds of pacemaker insertions each year and use the latest technology to treat abnormally slow heart rhythms.



What Is a Pacemaker?

A pacemaker is a small battery-powered device that is permanently implanted under your skin — most often in the shoulder area just under the collarbone. It sends electrical signals to regulate a slow or irregular heartbeat.

A pacemaker is a battery powered device. It is made up of a pulse generator that produces electrical signals, wires called leads that conduct electrical signals to the heart from the pulse generator, and electrodes.

Using electrodes attached to the generator and battery, the pacemaker is wired to your heart. Your pacemaker can "sense" when your heart's natural rate falls below the rate that the pacemaker has been programmed to maintain It can also determine when your heart rhythm becomes irregular (too fast and too slow). Using this information, the pacemaker figures out what electrical pulses your heart needs and how often they should be given.

Types of Pacemakers

There are three main types of pacemakers, including:

  • Single-chamber pacemaker, which uses one lead to connect the pulse generator to one chamber on the right side of your heart.
  • Dual-chamber pacemaker, which uses two leads to connect the pulse generator to two chambers of your heart.
  • Biventricular pacemaker, which uses three leads to deliver cardiac resynchronization therapy (CRT) for people who have heart failure.

Conditions we treat with pacemakers

  • Alternating fast and slow heartbeat (tachy-brady syndrome).
  • Blocked or delayed electrical signals in the heart (heart block).
  • Heart failure.
  • Slow heartbeat (bradycardia).

Why Would I Need a Pacemaker?

When your heart's natural pacemaker or electrical circuit malfunctions, the electrical signals in your heart often become erratic. Erratic electrical signals, also known as arrhythmias or abnormal heart rhythms, can cause your heart to beat too slow, too fast, or too irregularly. A permanent pacemaker can be used to correct an abnormal heart rhythm if it is too slow or erratic, or if the electrical pathways in your heart are blocked.          

Who’s a candidate for a pacemaker?

You may be a candidate for a pacemaker if:

  • You have a slow heartbeat.
  • You have a heartbeat that alternates between too fast and too slow.
  • You have blocked electrical pathways in your heart.

Is a pacemaker procedure a major surgery?

Pacemaker surgery is considered a minor medical procedure. You will receive local anesthesia, so you won’t feel any pain when the pacemaker is placed. You will also receive medication that will help you relax.

Alternatives to pacemakers

What Are the Risks and Complications of Pacemaker Insertion?

Pacemaker insertion is a safe and effective procedure when it is performed by an experienced electrophysiologist. However, there are risks associated with any medical procedure. Risks of pacemaker insertion include:

How serious is having a pacemaker put in?

Getting a pacemaker is a minor medical intervention. Serious complications are rare. However, because the procedure involves your heart, it is essential to follow all of your doctor’s instructions to reduce the risk of problems.

What Should I Expect from a Pacemaker?

Before: How to prepare for a pacemaker procedure

Your doctor will explain the pacemaker procedure to you and give you a chance to ask questions. To prepare for a pacemaker, you should:

  • Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
  • Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
  • Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure. 
  • Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
  • Fast for a certain period of time prior to the procedure. Your doctor will tell you how long to fast (usually overnight).
  • Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your pacemaker procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

You will need to stay in the hospital overnight after your procedure. You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should arrange for someone to drive you home from the hospital after you are discharged.

How long does a pacemaker procedure take?

A pacemaker procedure takes about an hour. You will need to stay in the hospital for a night or two after your procedure to make sure your pacemaker is working properly. You should arrange to have someone drive you home from the hospital after you are discharged.

During your pacemaker procedure

A pacemaker is inserted by your cardiologist in either the cardiac catheterization or electrophysiology laboratory. You will receive local anesthesia to numb the incision site. Sedation medication can be given to help you relax and many patients sleep during the procedure.

Your doctor will make a small incision just under your collarbone to insert the lead(s) into your heart through a blood vessel. After the lead is in place, it will be tested to make sure it is in the right place and is working properly. The lead is then attached to the generator, which is placed just under your skin through the incision.

Recovery after your pacemaker procedure

You may be taken to the recovery room for observation or returned to your hospital room where a nurse will monitor your vital signs. You should immediately inform your nurse if you feel any chest pain, tightness, or any other pain at the insertion site. The insertion site may be sore or painful, and pain medication may be administered if needed.

After a period of bed rest, you may get out of bed without assistance. A nurse will assist you the first time you get up and will check your blood pressure while you are lying in bed, sitting, and standing. You should move slowly when getting up to avoid any dizziness from the period of bedrest. You will be able to eat and drink after you are completely awake.

After your blood pressure, pulse, and breathing are stable, you will be taken to your hospital room. You will likely be required to spend a night or two in the hospital so your health care team can make sure your pacemaker is working properly.

How long does it take to recover after a pacemaker procedure?

After you arrive home, it will be important to keep the insertion site clean and dry. You will be given instructions about bathing and showering.

You should be able to return to your daily routine within a few days. Your doctor will tell you if you need to take more time before returning to your normal activities. In addition, you should avoid lifting or pulling on anything for a few weeks. You may be instructed to limit movement of the arm on the side where your pacemaker was placed depending on your doctor’s preferences.

Based on the nature of your job, your overall health and your progress, your doctor will determine how soon you may return to work. You will not be able to drive until your doctor says it’s OK. These limitations will be explained to you if they are applicable to your situation.

When to call your doctor about complications

Notify your doctor to report any of the following:

  • Chest pain or pressure, nausea and/or vomiting, profuse sweating, dizziness, and/or fainting.
  • Fast or fluttering heartbeat.
  • Fever and/or chills.
  • Increased pain, redness, swelling, bleeding, or other drainage from the insertion site.

Your doctor may give you additional or alternate instructions after the procedure, depending on your situation.

What’s the prognosis after a pacemaker procedure?

In most cases, you will be able to lead a normal life that includes daily activities and exercise after your pacemaker procedure.

What is the life expectancy of someone with a pacemaker?

With a pacemaker, you may live as long as any other person who does not have heart problems.

What are four things to be avoided if you have a pacemaker?

After implantation of a pacemaker, you must be aware of your surroundings and devices that may interfere with its operation. Potentially disruptive devices include those with strong magnetic fields, such as:

  • Electric fences.
  • Metal detectors.
  • MRI machines.
  • Personal devices that use magnets, such as headphones, ab stimulators, electronic body fat scales, and medical alert systems.

The manufacturers of pacemakers have different restrictions depending on your device. You should refer to the company’s guidelines for specific instructions regarding your pacemaker.

How long do pacemakers last?

Pacemakers generally last 5 to 7 years or longer, depending on usage and the type of device. You should have your pacemaker checked regularly to make sure it is working properly.

You will also receive an identification card from the manufacturer that includes information about your specific model of pacemaker and the serial number, as well as how the device works. You should carry this card with you at all times so that the information is available to any health care professional who may have reason to examine and/or treat you.

What’s the success rate of pacemakers?

Pacemakers are more than 95 percent effective for treating abnormal heart rhythms.

Why Choose UPMC for Your Pacemaker Procedure?

UPMC heart specialists implant hundreds of pacemakers each year and use the latest technology and techniques. If you require additional cardiovascular care, the specialists at UPMC have the skills and experience needed to perform advanced cardiovascular procedures and offer you the latest treatment options.


Last reviewed by a UPMC medical professional on 2024-10-01.