Is Pacemaker Implantation a Major Surgery?

A pacemaker is a small, battery-operated device that sends signals to the heart to regulate the heartbeat. The pacemaker senses when the heart beats irregularly (arrhythmia) or if it beats too slow (bradycardia) and sends corrective signals to the heart muscles. Modern-day pacemakers can fix arrhythmias and help restore normal heart function. This helps people with various heart conditions live a more active and long life. The device may weigh just 1 ounce. A pacemaker has two main parts:

• A generator: It contains the battery and the requisite information for controlling the heartbeat.
• Leads: They are wires connecting the heart to the generator. The leads carry the electrical messages from the generator to the heart.

The following is done for pacemaker surgery:

• Before the surgery, you will be asked to wear a hospital gown after taking a bath with a special soap.
• Your doctor may ask you to not eat or drink anything after midnight the night before the surgery. They may, however, allow you to take certain medicines with a small sip of water.
• You will lie on your back on the operating table.
• The doctor or nurse will administer a sedative to help you get relaxed.
• A local anesthetic will be injected at the site of operation. This ensures that you do not feel pain while you stay awake during the procedure.
• The doctor will make a small surgical cut (incision) on your chest. The incision is generally given on the left side of the chest a little below the collarbone.
• The pacemaker generator is placed under the skin below the collarbone. Rarely, the pacemaker generator may be implanted in the abdomen.
• The doctor will then insert the pacemaker leads through a vein. The leads are guided into the heart using live X-rays.
• Once the leads are at their correct positions, they are connected to the generator of the pacemaker.
• The doctor will then check whether the pacemaker is functioning properly.
• Once the functioning of the pacemaker is ensured, the incision is closed with stitches and dressing is done.
• The procedure generally takes around 1 hour to complete.
• The skin is closed with stitches.

The complications of a pacemaker surgery may include:

• Bleeding
• Infection
• Arrhythmia (abnormal heart rhythms)
• Injury to the lung (rare) leading to pneumothorax (presence of air between the lungs and the chest wall
• Injury to the heart (rare)