Pacemakers and Defibrillators

⚠️ Important Note:
The information on this page provides a general overview of the procedure. The exact instructions and experience may differ depending on the hospital or institution where your test is performed. If there is any difference between what is written here and what your medical team has told you, always follow the guidance provided by the team performing your procedure.

What is a pacemaker or defibrillator?

A pacemaker is a small device that helps your heart beat at a normal rate if it’s going too slowly.
An implantable cardioverter defibrillator (ICD) is similar, but also protects against dangerously fast rhythms by delivering a shock if needed.
A cardiac resynchronization therapy (CRT) device helps both sides of the heart beat in sync, and is often used in people with heart failure and delayed electrical conduction.

These devices are implanted under the skin near the collarbone and connected to the heart with small wires (called leads).

Why is this procedure done?

This procedure may be recommended if you have:

A slow heart rate causing dizziness, fainting, or fatigue
An abnormal rhythm that puts you at risk for sudden cardiac arrest
Heart failure with weakened pumping function and delayed electrical signals

These devices can reduce symptoms, improve quality of life, and in many cases, reduce the risk of life-threatening arrhythmias.

How do I prepare?

Fasting: You may be asked not to eat or drink anything for several hours before the procedure.
Medications: Your doctor may ask you to stop certain medications (such as blood thinners) temporarily. Bring a full list of your medications with you.
Allergies: Let your care team know if you have any allergies (especially to iodine, contrast dye, or antibiotics).
Transportation: Arrange for someone to take you home after the procedure. You won’t be able to drive yourself.
Pacemaker/ICD Information: You’ll be given an identification card after the procedure — be sure to bring it to all future medical visits.

If you’re unsure about any instructions, call your cardiologist’s office ahead of time.

What should I expect on the day of the procedure?

When you arrive:

You’ll be registered and meet the care team
An IV will be started for medications and fluids
The chest area will be cleaned and shaved
You’ll speak with your doctor before the procedure starts

Sedation is usually mild — you’ll be awake but relaxed. Some hospitals may use deeper sedation, depending on your health and preferences.

What does the procedure involve?

The procedure usually takes 1–2 hours. A small incision is made under the collarbone. Using X-ray guidance, the doctor places wires (leads) through a vein and into the heart, then connects them to the device, which is placed under the skin. The incision is closed with dissolvable stitches or staples.

Most people go home later the same day or the next morning.

What does the procedure room look like?

The procedure may take place in:

A cardiac electrophysiology lab
A specialized cardiac procedure room
A traditional operating room (depending on the hospital)

The room contains imaging equipment, heart monitors, and a sterile field. You’ll be cared for by a team that includes:

The implanting cardiologist or electrophysiologist
Nurses and cardiac technologists
A sedation nurse or anesthesiologist
Trainees (fellows or residents) if you’re at a teaching hospital

What should I expect after the procedure?

You may feel bruising or tenderness at the incision site
You’ll be monitored for a few hours or overnight
Arm movement on the side of the device will be restricted for several weeks (no lifting above shoulder height or heavy lifting)
You’ll receive clear instructions about wound care, activity limits, and your first device check (usually 1–2 weeks later)

Most people resume normal light activity within a few days.

Are there any risks?

Complications are uncommon, but may include:

Bleeding or bruising
Infection at the incision site
Dislodged leads (wires)
Damage to a blood vessel or lung (rare)

Your doctor will explain the risks and benefits specific to your condition before the procedure.

Living with a pacemaker or defibrillator

You’ll be given a device ID card — keep this with you at all times
Regular device checks will be done in person or remotely through a monitor at home
Most household electronics and appliances are safe — avoid placing devices like phones or headphones directly over the implant site
Airport security scanners are safe, but inform security staff that you have a device
You can usually return to walking and light activity within a few days, and full activity after 4–6 weeks

Frequently asked questions

Will I feel the device working?
You won’t feel anything from a pacemaker. If you have an ICD and it delivers a shock, it may feel like a quick, forceful jolt in your chest — startling but lifesaving.

Can I drive?
In some cases, you may not be allowed to drive for a period of time (especially if you had fainting episodes or received an ICD shock). Your doctor will advise based on your condition and provincial guidelines.

Can I use a microwave or cell phone?
Yes — modern devices are well shielded. Just avoid placing a phone directly over the device, and use the opposite ear when possible.

Can I travel?
Yes. Bring your device ID card and any remote monitor (if required). Metal detectors are safe, but let security staff know you have a pacemaker or ICD.

What about MRI scans?
Some newer pacemakers and ICDs are MRI-safe. Check with your cardiologist and always tell the MRI team you have a device.

How long does the device last?
Battery life depends on the device and how often it’s used — typically 5 to 10 years. Replacement is a simpler procedure done under local anesthesia.