Pacemakers (original) (raw)

A pacemaker is a small electrical device that’s put under the skin in your chest. It's used to treat some abnormal heart rhythms (arrhythmias) that can cause your heart to beat too slowly or miss beats.

Some pacemakers, called cardiac resynchronisation therapy (CRT) devices, can also help the chambers of your heart beat stronger and at the same time.

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How a pacemaker works

Your heart has something called a sinus node. Your sinus node sends out electrical impulses to make your heart beat. You can think of it as your heart’s natural pacemaker.

The job of a pacemaker is to take over the role of your sinus node if it's not working properly.

Electrical impulses are sent by the pacemaker device to tell your heart to pump and produce a heartbeat. Most pacemakers work just when they’re needed. Others send out impulses all of the time, called a fixed rate.

Pacemakers do not give your heart an electrical shock.

What a pacemaker looks like

outline of a body showing a pacemaker in the chest and leads into the heart

Pacemakers are usually 5 by 4 centimetres (smaller than a matchbox) and weigh about 20 to 50 grams.

It usually sits just under the skin near your collarbone and will have one or more leads that are placed into your heart through a vein. In rare cases, it can be put lower down under your ribs (near your stomach).

Most pacemakers are very reliable and comfortable.

Heart conditions you’d have a pacemaker for

You may need a pacemaker fitted if:

Having a pacemaker can improve your quality of life and for some people it can save their life.

Fitting a pacemaker

Having a pacemaker fitted is a common procedure and should not hurt. It’s normal to feel a bit nervous.

Finding out what to expect can help reassure you. Talk to your doctor or nurse if you have questions.

It takes about one hour but can take longer if you’re having other procedures or surgery at the same time.

There are different ways to have a pacemaker fitted. The most common procedure is called transvenous implantation.

You’ll be given local anaesthetic to numb the area. This means you’re awake but should not feel any pain. You may also be given sedation (a type of medicine) to help you relax and you'll feel sleepy.

A small cut, about 5 to 6 centimetres, is made on the left side of your chest. The wires that connect the pacemaker to your heart will be put into a vein and guided to your heart.

The pacemaker is then fitted into a small space in your chest, between your skin and your chest muscle.

The cut will be closed with a special type of glue or stitches.

Usually, you’ll stay overnight after having a pacemaker fitted and go home the next day. Your pacemaker will be checked before you leave to make sure it’s working properly.

Are there any complications?

Serious complications are not common.

Contact your GP, the pacemaker clinic or NHS 111 as soon as possible if you:

Call 999 if you feel like you cannot breathe.

Types of pacemaker

There are different types of pacemakers. The one you have will depend on your condition and symptoms.

All pacemakers have leads coming off them which connect the pacemaker to your heart. Your pacemaker can have:

Some people need a special pacemaker called a cardiac resynchronisation therapy (CRT) pacemaker. It’s used when the pumping chambers of your heart beat out of time with each other.

A CRT helps the chambers to pump at the same time and helps your heart pump better. It can be combined with other devices to help your heart, such as:

If you’re at risk of a dangerous, abnormal heart rhythm (arrhythmia) you’re more likely to have a device called an implantable cardioverter defibrillator (ICD) or a CRT-D.

Your doctor will talk to you about which type of pacemaker is most suitable for you.

Living with a pacemaker

It’s normal to feel tired for a few days after having your pacemaker fitted. Your chest, where you had the pacemaker fitted, will feel a bit sore. Most people can return to normal daily activities after a few days.

You’ll need to avoid driving for about one week. If you find wearing a seatbelt is painful after the procedure, try putting a soft jumper or small pillow between your pacemaker and the seatbelt.

You may also need to avoid certain exercise for up to six weeks. This includes not raising your arm above shoulder level on the side you had the pacemaker fitted. Speak to your surgeon or doctor to find out what’s safe for you.

You’ll be given a pacemaker identity card. It’s important to keep it with you all the time, so if you need any medical treatment the healthcare professional knows about your pacemaker. Call your pacemaker clinic if you do not have a card.

It’s normal to feel worried about living with a pacemaker, and you may have questions.

Frequently asked questions: flying, sex and scans

You'll also have follow-up appointments at the pacemaker clinic where you can ask questions. They should also give you a phone number to call if you have any questions or concerns.

Getting support

If you’ve been told you need a pacemaker or you’re living with one, we’re here to support you.

The future of pacemaker technology

A new pacemaker is currently being tested in a clinical trial. It’s smaller and does not have any leads. The pacemaker is put inside your heart, in your right ventricle.

Your specialist can give you more information about this type of pacemaker.