In short
A pacemaker is a small battery-powered device placed under the skin, usually below the collarbone, with one or more leads to the heart. It monitors the heart rhythm and sends electrical signals when the heart beats too slowly or pauses. It is used for specific rhythm problems — not as a general treatment for all heart conditions.
Who may be assessed
Pacemakers are usually considered when the heart’s natural pacemaker or electrical conduction system is not working reliably — for example, certain types of heart block or sinus node disease — particularly when this causes symptoms such as fainting, dizziness, breathlessness or tiredness. The decision depends on recordings of your rhythm and your symptoms.
What generally happens
Implantation is done in hospital, usually under local anaesthetic with sedation. A small incision is made below the collarbone, the leads are guided through a vein into the heart, tested, and connected to the device, which is placed in a pocket under the skin. Some newer devices are leadless and placed directly in the heart; your team will explain which type applies to you.
How it differs from other devices
A pacemaker mainly treats slow rhythms. An implantable cardioverter-defibrillator (ICD) treats dangerous fast rhythms, and cardiac resynchronisation devices help coordinate pumping in some people with heart failure. These are different decisions with different indications.
Risks and limitations
General risks include bleeding or bruising, infection, a lead moving out of position, and, uncommonly, a collapsed lung or damage to the heart or vein. A pacemaker does not treat blocked arteries or valve disease.
Living with a pacemaker
Pacemakers are checked regularly, and the battery is replaced when it runs low. You will receive guidance on precautions such as mobile phones, security scanners and medical equipment like MRI. Recovery and follow-up are planned individually. How long you stay, when you can drive, return to work or exercise, and any change to your medicines depend on your condition and the procedure, and are discussed with you by the treating team. Do not stop or change prescribed medicines unless the prescribing clinician advises it.
Where it takes place
Where a procedure is recommended, the practice will confirm the hospital venue, the admission arrangements and any preparation when your care is arranged. Procedures are not performed in the consulting suite.
Questions to ask your clinical team
- What rhythm problem has been found, and how do we know it explains my symptoms?
- What type of pacemaker do you recommend, and why?
- How will my device be checked, and how often?
- Are there activities or equipment I should be cautious with?
Common questions
Will a pacemaker help palpitations?+
Not usually. Pacemakers treat slow or paused rhythms. Palpitations have many causes and are assessed separately.
Sources and further reading
General patient education written in plain language and informed by the sources above. It is not a substitute for an individual assessment, and does not describe practice-specific fees, referral rules or preparation — please confirm these with the practice.