What happens during surgery?

Detailed information will be provided to you prior to surgery.

The surgery is similar for these procedures.

Your surgery takes place in a theatre and you will be given a local anaesthetic – to numb your collarbone area.
The doctor will make a small incision near your collarbone for the device.
If leads are required they will be threaded inside veins into your heart.
The doctor will connect the leads and device – performing tests to ensure it is working appropriately.

The incision will be closed using sutures and a dressing applied to the area.
You will be asked not to move your arm above your shoulders on the surgery side for 2 weeks.

Pacemaker Implant

A pacemaker is a small but sophisticated electronic device that is implanted under the skin. The unit comprises a battery and a powerful microprocessor and it provides a back up electrical supply to the heart. The pacemaker is attached to wires which are inserted into the heart through a vein under the collar bone. These wires (or leads) take the electricity from the pacemaker battery to the heart, keeping a person’s heart rate from going too slowly, and helping to coordinate the beating of the cardiac chambers.


The heart is a pump which has an electrical supply.
Your doctor may recommend a pacemaker if your heartbeat has become too fast, too slow or irregular – known as arrhythmia.

Arrhythmias can have many causes, including:

  • Ageing
  • Inherited or genetic
  • Previous heart attack or heart valve/muscle problems
  • Viral heart infections
  • Cardiac surgery – such as valve surgery or TAVI

Implantable Cardioverter Defibrillator (ICD)

ICDs are slightly larger than pacemakers and also monitor the heart for abnormal beating, but they can also deliver a shock if a dangerous rhythm is detected.


Some heart conditions are associated with an increased risk of sudden death due to a fast and dangerous heart rhythm called ventricular fibrillation. In certain circumstances your cardiologist may recommend an Implantable Cardioverter Defibrillator (ICD). This is a device similar to a pacemaker but has the ability to detect fast, abnormal heart rhythms, and if necessary, can deliver a shock to the heart which can terminate the rhythm problem and restore normal heart electrical supply.
While this sounds frightening, it can bring your heart rate back to normal and save your life.

Cardiac Resynchronisation Therapy

Cardiac Resynchronisation Therapy (CRT) is a type of permanent pacemaker or cardioverter-defibrillator which can improve the heart pumping function in patients suffering from heart failure.


The symptoms of heart failure could be breathlessness and ankle swelling and often the heart is enlarged and weakened.
Some patients with heart failure develop problems with the electrical impulses spread through the heart, this may cause the heart to pump in an “uncoordinated” manner. CRT delivers electrical impulses via the pacemaker wires to both the left and right sides of the heart (biventricular pacing).
It is not suitable for all heart failure patients.

Implantable Loop Recorder

An Implantable Loop Recorder (ILR) is a very small device which constantly monitors your heartbeat and records when symptoms are experienced.


The implantable loop recorder can help the cardiologist to determine if your symptoms are related to heart disease. For example:

  • Syncope (fainting)
  • Dizziness
  • Seizures (fits)
  • Light-headedness
  • Palpitations – heart racing