Individuals who require an internal artificial pacemaker to regulate their heartbeat will need to undergo pacemaker surgery to have the device implanted in the body. The procedure is performed under local anesthetic, though patients are generally hospitalized overnight for careful monitoring. Patients are given a mild sedative to keep them calm and relaxed but are otherwise awake and alert throughout the procedure.
To insert the pacemaker, the surgeon makes a two to three inch incision just below the patients collarbone. An electrode lead is inserted into a nearby vein and slowly advanced towards the heart. A fluoroscope is used to guide the doctor as he advances the lead, providing him with a detailed image of the interior of the vein. Once the lead enters into the heart, it is attached to the tissue so that the positioning of the lead may be tested. To test positioning, the surgeon sends small electrical signals down the lead and evaluates the hearts response to the impulses. A suitable position is one that allows the full strength of the signal to reach the heart, thereby signaling the heart to contract and beat. It may be necessary to reseat the lead within the vein...
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