The procedure is typically performed in an operating room or in a cardiac catheterization lab. Local anesthesia is given to numb the area of the chest where the procedure is performed, allowing the patient to remain awake while the surgery is performed without pain. In addition to numbing the area, a sedative may be given to help the patient relax or reach a twilight sleep state.
Once the anesthesia takes effect, the chest will be prepared with a special solution to remove germs that may be on the skin, and the area will be covered with sterile drapes to keep the incision as clean as possible.
The procedure begins with the insertion of the wires that attach the device to the heart. The wires are threaded through and into the heart where they are placed using a type of x-ray imagining that allows the doctor to see exactly where the wires are at all times.
Once the wires are in place, an incision is made in the chest or abdomen, and the actual pacemaker device is placed under the skin. The wires, which are connected to the heart, are attached to the pacemaker. The pacemaker is then tested to make sure it is working effectively.
Once the physician determines that the wires are in the correct place and the pacemaker is functioning properly, the incision is closed with sutures or adhesive strips and medication is given to wake the patient.