Permanent pacemaker living
Informed by recognized medical guidance
Overview
A permanent pacemaker is a small battery-powered device placed under the skin of your chest to help your heart beat at a steady, safe pace. It sends gentle electrical pulses to your heart when it beats too slowly.
Key facts
- A pacemaker does not replace your heart's natural rhythm; it steps in when your heart rate drops too low.
- Most pacemakers are implanted under the collarbone and are about the size of a matchbox.
- You will still need regular check-ups to make sure the pacemaker is working well and the battery has enough power.
Yes. Many thousands of people around the world live with permanent pacemakers. It is one of the most common heart device procedures.
People of any age can need a pacemaker, but it is most often used in older adults with slow heart rhythms. Children with certain heart conditions may also have one.
Symptoms
- Chest pain or pressure
- Difficulty breathing that is not normal for you
- Fainting or collapse
- Pain spreading to the arm, neck or jaw, which could be a heart attack
- Seizure caused by a very slow heart rhythm
- Constant jolting or twitching you feel from the pacemaker
- ⚠A fever with redness, warmth, or fluid leaking from the incision
- ⚠Persistent dizziness that does not go away when you rest
- ⚠A new, irregular heartbeat or palpitations that last more than a few seconds
- ⚠Swelling of the leg or arm on the same side as the pacemaker
Common symptoms
- Dizziness or light-headedness
- Palpitations (a feeling that the heart is fluttering or skipping)
- Swelling, redness or tenderness near the pacemaker pocket
- Frequent hiccups that stop and start (a rare sign of the lead irritating the diaphragm)
- Feeling very tired or breathless
Symptoms in children
- Fussiness or irritability in a baby
- Poor feeding or slow weight gain
- Fainting or 'going limp' during activity
Symptoms in older adults
- Confusion or unusual drowsiness
- Falls or a sudden drop in energy
- Shortness of breath during normal activity
Causes
Main causes
- Your heart's natural pacemaker stops working properly (sick sinus syndrome)
- Heart block — the electrical signal gets blocked between the upper and lower chambers of the heart
- Damage to the heart from a heart attack, heart surgery, or certain medications
Risk factors
- Getting older
- Having coronary artery disease
- Having had heart surgery
- Taking medicines that slow the heart rate (your doctor will advise if these are needed)
When to see a doctor
See a doctor urgently if:
- Call for emergency help immediately if you have any of the emergency symptoms listed above
- If you have urgent symptoms like persistent dizziness or signs of infection, contact your doctor or hospital the same day
Book a routine appointment if:
- Attend all scheduled pacemaker checks
- See your doctor if you have questions about activities, travel, or your medicines
Diagnosis
Before recommending a pacemaker, your doctor will do tests to find the cause of your slow heart rhythm. After the pacemaker is placed, regular checks make sure it is working correctly.
Tests that may be done
- Electrocardiogram (ECG) — a quick test that records the heart's electrical activity
- Holter monitor — a portable ECG you wear for 24 to 48 hours
- Echocardiogram — an ultrasound of the heart to check its structure
- Pacemaker interrogation — a clinic test where a computer reads the pacemaker's memory and settings
What to expect at your appointment
The clinic visit usually takes about 15 minutes and is painless. The nurse or technician puts a wand on your chest, the pacemaker 'talks' to the computer, and you get a report. You can go home right after.
Treatment
The pacemaker is the main treatment for a heart rate that is too slow. It does not cure heart disease, but it helps you feel more energetic and avoids dangerous pauses in your heartbeat.
Self-care at home
- Keep the incision area clean and dry for the first week
- Do not raise your arm above your head on the side of the pacemaker until your doctor says it's safe
- Avoid heavy lifting or contact sports for at least 4–6 weeks
- Carry your pacemaker ID card at all times
- Tell all doctors and dentists that you have a pacemaker
Medical treatments
Your doctor may adjust your pacemaker settings during check-ups to match your needs. Some people also take medicines for heart failure or other conditions. Keep taking all prescribed medicines as directed by your healthcare provider.
When is surgery considered?
Pacemakers are implanted under local anesthetic, so you are awake but the area is numb. Most people go home the same day or after one night. The pacemaker battery lasts 5 to 10 years; when it gets low, it is replaced with a small procedure.
Living with this condition
You can lead an active life. Most everyday activities — walking, swimming, driving, and traveling — are safe with a pacemaker. You'll need to avoid strong magnetic fields and always inform airport security about your device.
Lifestyle tips
- Avoid MRI scanners unless your pacemaker is MRI-safe and your doctor gives the go-ahead
- Keep your phone at least 15 cm (6 inches) away from your pacemaker when it's on
- Avoid strong electric fields, like welding or high-voltage equipment
- Tell your doctor if you start a new job that uses heavy electrical machinery
- Do not lean directly over a microwave oven or use a large appliance's motor right next to your chest
Diet and exercise
Eat a heart-healthy diet with plenty of vegetables, whole grains, and lean protein. Gentle exercise like walking, swimming, and cycling is encouraged. Build up gradually and ask your cardiologist before starting high-intensity training or contact sports.
Mental health and emotional wellbeing
It is common to feel anxious, self-conscious, or sad after getting a pacemaker. Talk with your doctor or a counselor if those feelings last. You are not alone — many people go through the same adjustment.
Prevention
You cannot prevent the heart conditions that lead to needing a pacemaker. But you can reduce your risk of heart disease with healthy habits, and you can prevent pacemaker infections by keeping the skin around the device clean.
Vaccines
Stay up to date with flu and other recommended vaccines. Infections can be harder to manage if you have a heart device. Talk to your doctor or pharmacist about which vaccines are right for you.
Screening programmes
Regular pacemaker checks are the best screening you can have. They make sure the battery, leads, and settings are all working correctly.
Complications
If left untreated
- If a pacemaker stops working or an infection is not treated, you could faint, have heart failure symptoms, or, rarely, develop a dangerous heart rhythm.
- An infected lead can spread to the heart.
- These problems are serious but usually treatable if you seek help quickly.
Long-term outlook
Most people feel much better after getting a pacemaker. It can add years of good quality life. With regular care, you can watch your grandchildren grow, spend time with friends, and enjoy your hobbies — while your pacemaker quietly does its job.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.