Pacemaker Implantation

A pacemaker is implanted for certain types of bradycardia and disorders of electrical impulse conduction in the heart, most often sinus node dysfunction and atrioventricular block. An arrhythmologist decides based on the type of disorder, symptoms, ECG results and other tests. In certain types of AV block a pacemaker may be needed even without marked complaints.

The operation is done under local anesthesia and takes about an hour. A small incision is made under the collarbone, the leads are passed through a vein into the heart under X-ray guidance, connected to the pacemaker, and the device is placed under the skin or muscle. Finally, it is adjusted and tested.

The incision area is numbed with local anesthesia during the operation. For a few days afterwards there may be moderate discomfort around the incision, which goes away on its own.

Patients usually stay in hospital for 3–4 days. Before discharge, doctors recheck and fine-tune the device.

There are different types of pacing systems. They differ in the number and position of leads, the pacing mode and additional functions. In some situations cardiac resynchronization therapy devices, conduction system pacing or devices with a defibrillation function are used. The physician chooses the best option based on the rhythm disorder, the condition of the heart and the patient’s individual characteristics.

The battery usually lasts several years, on average 7–10, depending on the model and how often the pacemaker works. When it runs down, the device itself is replaced. The pacemaker is checked at scheduled visits, so the time for replacement is known in advance.

When the battery runs down, the pacemaker body is replaced. Working leads are kept if they can stay. The physician decides on the scope and timing of the procedure after checking the device.

For the first 4–6 weeks, limit strain on the arm on the pacemaker side: do not lift heavy objects or raise the arm sharply above the head. Do not hold phones or magnets right against the device, and keep to the check-up schedule. Your physician will give other recommendations.

Whether an MRI is possible depends on the entire implanted system — the pacemaker and the leads. Many modern systems allow MRI under certain conditions. Before the scan, the device must be checked and set up accordingly.

Yes. Show your pacemaker patient card at security. Hold the phone to the ear on the opposite side and do not carry it in a breast pocket over the device.

Most patients return to their normal lives: they walk, travel, drive and exercise. Agree on the type and intensity of exercise with your physician.

Check-ups are usually 3, 6 and 12 months after the operation, then on the physician’s schedule. The battery charge and lead function are checked and the settings are adjusted if needed.

Yes. At Pirogov Clinic implantation is performed free of charge under CHI and federal quotas when indicated and with a referral. The step-by-step route is described in How to get care at the Center.