17360 Permanent Pacemaker
Overview
A permanent pacemaker is a small, battery-powered device that is placed under the skin, usually near your collarbone. It sends tiny electrical signals to your heart to help it beat at a safe, regular rate. It is used when your heart's natural electrical system is not working properly, often because your heart beats too slowly.
Key facts
- It is a small device, about the size of a small matchbox, placed under the skin.
- It helps your heart keep a safe rhythm and can reduce symptoms like dizziness and fainting.
- Most people go home the same day or the next day after the procedure.
Yes. Pacemaker implantation is a common procedure, and many people live active lives with one.
It is most often needed by older adults, but people of any age can need a pacemaker, including children with certain heart rhythm problems.
Symptoms
- Call your local emergency number immediately if you have any of these symptoms:
- Fainting or passing out
- Severe chest pain or pressure
- Sudden severe shortness of breath
- A very slow heartbeat with confusion, collapse, or unresponsiveness
- ⚠Dizziness that does not go away
- ⚠New or worsening shortness of breath
- ⚠Feeling very tired with a slow pulse
- ⚠Swelling in your legs or ankles
Common symptoms
- Feeling faint or actually fainting
- Feeling dizzy or light-headed
- Being much more tired than usual
- Shortness of breath, especially with activity
- A heartbeat that feels too slow, fluttering, or uneven
- Chest discomfort or a feeling of pressure
Symptoms in children
- Being unusually sleepy or hard to wake
- Feeding poorly or not gaining weight
- Blue lips or skin, especially during feeding or crying
- Fainting or near-fainting
Symptoms in older adults
- Confusion or memory problems that come and go
- Falls or unsteadiness
- Feeling weak or very tired
- Shortness of breath with light activity
Causes
Main causes
- Heart block – when electrical signals do not travel normally from the top to the bottom of the heart
- Sick sinus syndrome – when the heart's natural pacemaker is too slow or pauses
- Damage to the heart from a heart attack or heart surgery
- Age-related changes in the heart's electrical system
- Some medicines that slow the heart rate (your doctor will check this)
Risk factors
- Older age
- Coronary heart disease or a previous heart attack
- High blood pressure
- Diabetes
- Certain genetic heart conditions
- Having certain heart procedures or surgery
When to see a doctor
See a doctor urgently if:
- You feel faint or dizzy often
- Your heartbeat feels very slow or uneven
- You are more tired than usual and short of breath with light activity
Book a routine appointment if:
- You have been told you have a slow heartbeat
- You have a family history of heart rhythm problems
- You have symptoms that worry you, even if they seem mild
Diagnosis
Your doctor will ask about your symptoms and do a physical exam. They may use tests to check your heart's electrical activity and rhythm. These tests help your care team decide whether a pacemaker could help you.
Tests that may be done
- Electrocardiogram (ECG) – a quick, painless test that records your heart's electrical signals
- Holter monitor – a small portable device you wear for a day or more to record your heart rhythm
- Echocardiogram – an ultrasound scan that shows your heart's structure and how it pumps
- Blood tests – to check for other causes of your symptoms
- Exercise stress test – to see how your heart works when you are active
What to expect at your appointment
Most of these tests are quick and painless. Your doctor will explain the results and talk with you about the best next steps.
Treatment
A permanent pacemaker is placed during a short procedure, usually under local anaesthetic with some sedation. The device is put under the skin near your collarbone, and thin wires connect it to your heart. It sends gentle electrical signals only when your heart needs them.
Self-care at home
- Follow your care team's advice about keeping the wound clean and dry
- Check the wound for redness, swelling, or discharge, and tell your care team if you notice these
- Avoid heavy lifting and vigorous arm movements for a few weeks, as advised
- Carry your pacemaker ID card with you at all times
- Go to your follow-up appointments so your device can be checked
Medical treatments
Treatment includes the pacemaker itself, which is adjusted and checked by your care team. They may also treat any underlying heart condition. Your doctor will discuss the best plan for you. This article does not recommend specific medicines; ask your healthcare provider about any medicines you need.
When is surgery considered?
Your care team may recommend a pacemaker if your heart beats too slowly and causes symptoms, or if you are at risk of dangerous slow heart rhythms. The decision is based on your tests, symptoms, and overall health.
Living with this condition
Most people get back to normal activities within a few weeks. You will have regular check-ups, sometimes in person and sometimes remote. Your pacemaker's battery and settings are checked at these visits.
Lifestyle tips
- Avoid strong magnets or heavy electrical equipment near the device – ask your care team what is safe
- Tell all your healthcare providers, including dentists, that you have a pacemaker
- Use a mobile phone on the opposite ear to the device
- Carry your pacemaker ID card with you
- At airport security, show your ID card and ask staff for a hand search if you prefer
Diet and exercise
Eat a heart-healthy diet and stay active. Your care team will tell you when you can return to exercise. Gentle walking is often encouraged soon after the procedure. Always follow your own care team's advice.
Mental health and emotional wellbeing
It is normal to feel worried or anxious about having a pacemaker. Many people feel more confident once they see it helping their symptoms. If you feel low, anxious, or overwhelmed, talk to your doctor. If you have thoughts of harming yourself, contact your local crisis service or emergency services right away.
Prevention
You cannot always prevent the heart rhythm problems that need a pacemaker. But you can look after your heart by not smoking, eating well, staying active, and managing conditions like high blood pressure and diabetes.
Vaccines
Keep up to date with recommended vaccines, especially flu and pneumonia vaccines, as infections can be harder on your heart. Ask your doctor which vaccines are right for you.
Screening programmes
There is no routine screening for needing a pacemaker. But regular check-ups for heart conditions can help find problems early.
Complications
If left untreated
- Untreated slow heart rhythms can cause fainting, falls, or serious injury
- In rare cases, a very slow heartbeat can be life-threatening
- You may feel very tired and short of breath, making daily life harder
Long-term outlook
With a pacemaker, most people have a good outlook. The device helps prevent symptoms and serious problems. Many people live full, active lives. Your care team will support you.
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Always verify with your doctor
Health guidance differs by country and region. This page is general education and may not match the guidelines, medicines, or practice where you live. Discuss your concerns with your own doctor or healthcare provider, and follow local guidance where it exists.
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.
Related conditions
Sources and guidance
No guideline names this topic
No health guideline or clinical chapter that names this exact topic is cited here. This page is for general education and information only. It is not a diagnosis, a treatment plan, or personal medical advice. Check with your own doctor and follow their advice. If symptoms are severe, sudden, or worrying, get medical care promptly, and call your local emergency number in an emergency. Ruqelo LLC is not responsible for medical or legal outcomes from decisions based on this information.
Last updated: November 3, 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.
Guidance may differ by country or region. Confirm local recommendations with a qualified healthcare provider.