What is Involved in a Pacemaker Placement?

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  • Written By: M. DePietro
  • Edited By: W. Everett
  • Last Modified Date: 09 January 2020
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A pacemaker may be needed in people who have heart conditions that cause the heart to beat too slowly. It helps by sending an impulse to the heart that makes it beat faster. Pacemaker placement involves surgery to implant the device. It is usually done under a numbing anesthesia and involves a small incision. Most people do not have serious complications and the procedure is considered a relatively minor surgery.

Pacemaker placement is often done on an outpatient basis. An intravenous line will be placed to deliver antibiotics to prevent infection. Medications to help the patient relax may also be given. In most cases, a numbing topical medication will be applied to the area of the incision to prevent the patient from feeling pain.

Although it is considered a safe surgery, patients are still monitored closely during pacemaker placement. EKG leads are placed on the chest to monitor heart rate. A blood pressure cuff is placed on the arm and medical workers will intermittently measure blood pressure. An oxygen saturation probe will be put on the finger to monitor the oxygen level in the blood during pacemaker placement. Monitoring the patient’s vital signs helps determine if the patient is tolerating the pacemaker procedure and remaining stable.


Once all the monitoring is set up and the patient is numb, doctors make an incision in the chest wall. The wires or leads are inserted through the incision and threaded up to the heart through a vein. These wires are then attached to the heart. On the other end of the wires, the pacemaker is implanted under the skin at the site of the incision.

After pacemaker surgery, if the device detects the heart is beating too slowly, it will send an electrical impulse through the wires to the heart to speed it up. The doctor will decide how low to allow the heart to beat before the device will send the impulse. The device is than set to deliver the impulse when the heart reaches that rate.

Patients will be monitored for a few hours after pacemaker placement to be sure the device is working properly. A x-ray of the chest is usually taken to confirm proper placement of the pacemaker parts. Many patients are discharged the same day as the surgery if all goes well.

Pacemaker complications do not occur too often, but they can develop. Bleeding and an infection are possible complications. Another rare risk is a blood clot, which can develop and travel to the lungs.



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