A pacemaker insertion is the implantation of a small electronic device that is usually placed in the chest (just below the collarbone) to help regulate slow electrical problems with the heart. A pacemaker may be recommended to ensure that the heartbeat does not slow to a dangerously low rate. The pacemaker sends electrical pulses to your heart to keep it beating regularly and not too slowly. Having a pacemaker can significantly improve your quality of life if you have problems with a slow heart rate. The device can be lifesaving for some people. Types of pacemakers - Your doctor will decide what type of pacemaker you need based on your heart condition. Your doctor also determines the minimum rate (lowest heart rate) to set your pacemaker. • Leadless Pacemaker – Self-contained device without connecting leads (wires) and generator • Biventricular Pacemaker – also called cardiac resynchronization therapy (CRT) Why do I need a pacemaker? The heart is essentially a pump made of muscle, which is controlled by electrical signals. These signals can become disrupted for several reasons, which can lead to a number of potentially dangerous heart conditions, such as: • an abnormally slow heartbeat (bradycardia) • an abnormally fast heartbeat (tachycardia) • heart block (where your heart beats irregularly because the electrical signals that control your heartbeat aren’t transmitted properly) • cardiac arrest (when a problem with the heart’s electrical signals cause the heart to stop beating altogether) How is a pacemaker fitted? Having a pacemaker implanted is a relatively straightforward process. • It’s usually carried out under local anaesthetic, which means you’ll be awake during the procedure. • The generator is usually placed under the skin near the collarbone on the left side of the chest. The generator is attached to a wire that’s guided through a blood vessel to the heart. • The procedure usually takes about an hour, and most people are able to leave hospital on the same day or a day after surgery. What are the risks of the procedure? Possible risks of pacemaker include, but are not limited to, the following: • Bleeding from the incision or catheter insertion site • Damage to the vessel at the catheter insertion site • Infection of the incision or catheter site • Pneumothorax. If the nearby lung is inadvertently punctured during the procedure, leaking air becomes trapped in the pleural space (outside the lung but within the chest wall); this can cause breathing difficulties and in extreme cases may cause the lung to collapse.