Permanent Pacemaker Implantation 
If the heart rate is too slow, a pacemaker may be necessary to electrically stimulate the heart. Placement of a permanent pacemaker requires overnight hospital stay but could be a day procedure. This is done under local anesthetic. A small incision is made in the shoulder level (usually on the left side in right-handed patients), below the clavicle. A pocket is performed under the skin and one or two tiny wires (“leads”) are advanced through a vein into the right heart chambers. These leads are connected to the pacemaker battery can and are sutured in place. The pacemaker will only pace the heart when the heart rate is below the pacer set rate. The battery lasts 3 to 12 years with an average of 5-7 years. Replacement of the pulse generator (can that contains the battery and electronics) is easy requiring only a few hours in the hospital.