Permanent Pacemaker Implantation

A permanent pacemaker(PPM) is implanted to treat bradycardia (an abnormally slow heart rate). Pacemakers can also adjust the heart rate to meet the body’s needs, whether during exercise or rest.

The PPM may be implanted using general anaesthesia, or conscious sedation and local anaesthesia. Antibiotics are given before and occasionally after the procedure to prevent infection.

A small incision is made in the area of the left chest wall beneath the collar bone to create a pocket for the generator and to access a suitable vein to pass one or more wires (leads) into the heart using x-ray control.

The PPM consists of two parts: a ‘’pulse generator ‘’ containing the battery and electronic circuits, and one or more leads. Once a suitable location is identified, the leads are screwed or inserted into the heart muscle and then connected to the ‘’ box’’ (pulse generator)

The cardiologist will then close the wound with dissolvable stiches and apply a sterile dressing directly over the area.

What are the risks of Permanent Pacemaker implantation?

In general, there is a 1-2% chance of complications which may include:

  1. Collapsed lung (pneumothorax)
  2. Excessive bleeding/bruising
  3. Infection
  4. Damage to the heart muscle and/or blood vessel walls
  5. Blood clots in veins that are used in passing the leads to the heart
  6. A remote possibility of heart attack, stroke or death following the procedure
  7. A small risk of reacting to the antibiotics or dye (contrast) which is occasionally injected to facilitate passage of the wires into the blood vessels
  8. Complications related to the anaesthetic or sedation given during the procedure

The actual risk of harm resulting from PPM implantation may be lower or higher, depending on your medical circumstances. The cardiologist will discuss this with you before the procedure.

Before you are discharged from hospital, you will have a chest x-ray, PPM check, PPM identification card and you will be given advice about activities you should or shouldn’t be doing, safety around appliances with magnetic fields and precautions to take at airports.

It is important to remember that if you notice any problems with the healing of the wound you must contact your cardiologist immediately particularly if there is any redness, swelling or pain around the incision site, fever or bleeding from the site. A small amount of bruising following the procedure is completely normal.