Before the procedure
- You’ll have tests (like ECG, blood tests, maybe imaging) to confirm the need for a pacemaker.
- You may be asked to stop eating/drinking for several hours beforehand.
- Your doctor will review medications—some may need to be paused (e.g., blood thinners).
During the procedure
Pacemaker implantation is a minor surgical and takes around 30 minutes – two hours depending on the type and complexity of the pacemaker. A pacemaker can have one, two or three ‘leads’ (wires into the heart) (or in certain circumstances can be ‘leadless’).
- You’ll be awake but offered a sedative to relax you.
- The area (usually below the collarbone) is numbed with local anaesthetic.
- The doctor inserts thin wires (leads) into a vein and guides them into your heart.
- The pacemaker device is placed under the skin and connected to the leads.
You shouldn’t feel pain—just some pressure or movement.
After the procedure
- You’ll be monitored for several hours or overnight.
- Your heart rhythm will be checked to make sure the pacemaker is working correctly.
- The area may feel sore, bruised, or tight for a few days.
Most people go home the same day or the next day.
Recovery
- You’ll need to limit arm movement on the side of the implant
(no lifting above shoulder height for ~2–4 weeks) - Avoid heavy lifting or strenuous activity initially
- The wound should heal within a couple of weeks
Risks and complications
Serious complications are uncommon (around 1%), but it’s good to be aware of them:
- Infection at the implant site
- Bleeding or bruising
- Lead displacement (wires moving out of place)
- Rarely, lung complications (like a punctured lung)
Doctors monitor closely to catch these early.
Follow-up care
- You’ll have a check-up within a few weeks
- After that, you will have periodic monitoring (often done remotely)
- The device settings will be adjusted to suit your personal needs – this can be straightforward but can take some refinement over a period of time as you and your pacemaker get used to each other