Permanent pacemakers

A pacemaker is a small device (about the size of a wristwatch) that is implanted under the skin of your chest. The pacemaker is made up of two parts, a battery and the pacemaker leads (wires). The battery is attached to the pacemaker leads which then run into your heart.

A pacemaker may be used if your doctor has determined your heart may beat too slowly or if it has the potential to slow down occasionally. Common symptoms of a slow heartbeat are falls/blackouts (syncope) and occasionally the inability to tolerate exercise.  

How it works

Pacemakers work by monitoring your heartbeat. The battery receives signals from the pacemaker leads and a small computer checks that your heart rate is appropriate. If your rate is too slow, the pulse generator will take over and send a small electrical signal to your heart that will increase your heart rate. This electrical signal is painless. Your pacemaker will help you maintain an even heart rate but it cannot prevent your heart from going too fast. If you have a fast heartbeat, your doctor will discuss other options for you. 

What to expect

  • The procedure is performed in a sterile environment usually the electrophysiology (EP) laboratory (lab) at Kingston Health Sciences Centre's Kingston General Hospital site.
  • After arriving in the Admitting department, you will be moved to the Cardiac Sciences Unit where you will be greeted by a nurse.

  • The nurse will begin by placing an intravenous (IV) line into a vein and checking your vitals.

  • Sometime before your procedure, you will be asked to sign a consent form. At this time you may also speak with the doctor and ask any questions you may have.
  • You will then be asked to lay on a stretcher and will be moved into the EP lab.
  • A nurse will make sure you are comfortable throughout the procedure using sedation drugs.
  • The procedure is performed using an X-ray, so if you are a woman of childbearing age it is important you confirm you are not pregnant before the procedure begins.
  • You will remain awake through this procedure. A local anaesthetic will be used to numb the area where the pacemaker will be inserted.

  • A small incision will be made below the collarbone usually on your left side and the device will be implanted. The procedure can take one to two hours depending on the type of pacemaker you receive.

  • An overnight stay is not usually required, but you should come to the hospital prepared to stay overnight just in case. Before you are able to go home, you will be met by your care team who will discuss medications with you.

  • Please make sure you have made arrangements for your ride home as you won't be able to drive.

  • If you would like more information about home care after your procedure is complete, read our Cardiac Rhythm Device Home Care Guide.