Background
The pacemaker is a small device whose main purpose is to maintain the heart rate above a minimum threshold. The system consists of a generator that contains the battery, and one or two leads (wires) that are implanted, first and rest in the heart and sense your heart beat. The batteries in pacemakers generally last for 5-10 years.

Preparation
Please do not eat or drink after midnight before the procedure. If you take coumadin (warfarin) we will ask you not to take it for several days prior to the procedure. Other daily medications, including the cardiac drugs should be taken with a little sip of water.

During the procedure
You will lie on an x-ray table, with a sterile drape over your entire body. The physician will numb the site of implant (typically near the left or right shoulder, just under the collarbone) with a local anesthetic, and you will receive intravenous sedative and pain medication to maximize your comfort. An incision about 1.5 inches long is made, and a vein is identified through which one or two leads are threaded to the heart using X-ray guidance. You may experience some discomfort during the placement of the leads, but it is generally momentary. After the leads are positioned, they are attached to the pacemaker generator, which rests under the skin. The incision is sewn up using absorbable sutures. The procedure generally takes 1.5 to 2 hours to complete.