What to expect during a pacemaker ICD implant procedure


The Pacemaker/ICD Device implant

  1. Do not eat the night before the procedure
  2. Arrive early in the morning at the hospital
  3. Bring a list of all your medications
  4. A peripheral intravenous line will be set up on the side the pacemaker will be implanted, usually the left side
  5. You will be wheeled to the theatre where you will meet a team of doctors, technologists and nurses . The team will be dressed in the appropriate theatre attire
  6. Your chest area will be shaved(if necessary), washed with sterile solution , and sterile sheets will be placed over you. It is important not to move or touch the sheets once in place.
  7. During the procedure you will receive medications through the IV line. The medications will make you feel very relaxed and you may even drift off into a light sleep. To ensure your comfort pain medications can be topped up through the IV line as required
  8. A local anaesthetic is given to numb the area below your collar bone , which is where the pacemaker is inserted
  9. Once the anaesthetic has taken affect a small incision is made. Using special X-rays , the pacemaker/ICD leads are threaded and secured into your heart via a  selected vein . A pocket under the skin is then created for the pulse generator. The pacemaker lead is connected to the pulse generator which is positioned in the pocket. You  will feel some pressure during the procedure . If you have any discomfort , let the team know and you will be topped up with pain medications
  10. Once the pacemaker/ICD is implanted the incision site will be closed with self dissolving stitches . They do not need to be removed.
  11. The procedure can take 1-2 hours to complete

Post –Procedure

After the procedure you will go to a monitored bed .

Your heart rhythm , rate , blood pressure, oxygen saturation will be monitored

You will have an ECG and Chest X-ray to ensure proper placement and functioning of the pacemaker

If you have any discomfort at the incision site let the ICU staff know Repositioning and pain medications as will snacks and a drink will be available.

Once you are feeling better  (usually 6-12 hours) you will be able to go home. Please ensure you have some one to drive you home and possibly stay with you for the first 24 hours.

You can remove the initial bandage 10 days after the procedure. Leave the area open, dry and do not put any moisturizers ,creams on the incision site

Keep the incision site dry for the first ten days.

You may experience some swelling , bruising and discolouration at the site of the pacemaker/ICD implant. This is particularly noticeable if you are on a blood thinner.

This is usually  resolves in 2-4 weeks.

Activity Guidelines

  • During the recovery period of the first two weeks , avoid lifting the arm on the side of the implant above your head as this may dislodge the  pacemaker leads.
  • Do not lift heavy objects for the first month after the pacemaker implant.
  • Do not engage in any vigorous sport i.e. tennis, swimming, golf, sweeping, shovelling or Toy -Toying in the first month after the pacemaker implant.
  • After the first month you may go back to regular activities you did before the procedure


If you experience any of the following, please contact your doctor immediately

  • A lump that keeps getting bigger
  • Redness , tenderness or warmth around the incision
  • Yellow pus or other fluids seeping from the incision
  • Severe pain at the incision site
  • Chills or fevers


  • You will be seen in the rooms of Dr V Thomas 2-4 weeks after the pacemaker implant.
  • Please bring a list of  all your medications
  • The implant site will be assessed
  • A C Xray , ECG  and pacemaker interrogation will be scheduled to assess and optimize the functioning of your pacemaker/ICD
  • Regular visits will be scheduled thereafter

Medic Alert Bracelet

It’s a good idea to get an alert bracelet or necklace that tells the public about the device you implanted in case of an emergency. You can call the  Device company or order them from: www.medicalert.ca

Frequently asked questions

Can I use my cellphone?

Yes, Its  you can use a cellphone. Its recommended that when talking or simply carrying a cellphone , you keep it on the side of your body opposite to the pacemaker

Can I use a microwave?

Yes, you can use a microwave

Can I go through a security system in the airport?

Yes , you can go throught the airport security screening . It will not affect the pacemaker function. The system may however detect your device and set off the alarm. Present your device identification card to the security personnel . Ask they clear you after a hand search and they not use the handheld screening wand because it may affect your device

How long will my pacemaker/ICD last?

Pacemakers/ICDS last anywhere between 5-10 years with an average of 7 years , before the pulse generator has to be replaced . The length of time depends on how hard the  pulse generator has to work which is affected by how your pacemaker is programmed to pace your heart or how many ICD shocks you recieve. The functioning and pacemaker/ICD programming is reassessed at each visit.