Understanding Arrhythmia
Learn what arrhythmia is, why it happens, warning signs, risk factors, complications, and treatment options. A complete guide by Prakash Hospital for better heart health.
12 Dec 2025
by Prakash Hospital
Cardiology
Pacemaker Implantation
A small device under the skin stops your heartbeat from dropping too low, so the blackouts and dizzy spells of a slow heart can stop.
- Procedure duration
- About 1 to 1.5 hours
- Anaesthesia
- Local, with mild sedation
- Hospital stay
- Usually 1 to 2 nights
- Recovery
- 4 to 6 weeks of arm precautions
On this page
Overview
The pulse counted at your check-up was 38. That explained the dizziness every time you stood up, and the evening you blacked out in the bathroom. When the heart's electrical system slows down or stalls, the brain and muscles don't get enough blood.
A pacemaker is a battery-powered device about the size of a matchbox, placed under the skin below the collarbone. One or two thin wires (leads) run from it through a vein into the right side of the heart. It watches every beat, and if your heart rate drops too low or pauses, it sends a tiny pulse that you won't feel. When your own rhythm is fine, it simply waits.
If a slow heart is causing your symptoms, a pacemaker usually stops the blackouts and brings your energy back within days. It doesn't clear blocked arteries or strengthen a weak heart muscle. The battery lasts about 7 to 12 years, and then the device is swapped in a shorter procedure, usually keeping the same leads.
Our cardiology department finds the cause of a slow heartbeat with ECG, Holter monitoring and echocardiography, and coordinates pacemaker implantation with experienced cardiac surgeons. Your cardiologist explains the procedure and long-term plan beforehand and stays involved in your follow-up.
Why it's done
A pacemaker is advised when a slow or interrupted rhythm causes symptoms or risks sudden collapse, once reversible causes such as medicines or an underactive thyroid have been ruled out.
- Sick sinus syndrome, where the heart's natural pacemaker is too slow or pauses
- Complete heart block, usually even if you feel well
- Advanced second-degree heart block on an ECG or Holter recording
- Atrial fibrillation with a very slow rate that causes symptoms
- A slow rate caused by a medicine you genuinely need, such as a beta-blocker
- Some types of heart failure, where a three-lead device helps both sides of the heart beat together
Is it right for you?
Usually a good fit
- An ECG or Holter recording links your symptoms to a slow rhythm or pauses
- Reversible causes such as medicines, thyroid problems or high potassium have been treated
- You're fit for a procedure under local anaesthetic, which includes most elderly people
May not be suitable
- A slow pulse that settles once a medicine, thyroid problem or high potassium is corrected
- A naturally slow pulse without symptoms, common in fit young people and during sleep
- Fever or an infection, until it clears. A temporary pacing wire can bridge the gap if needed
- Fainting from another cause, such as a drop in blood pressure on standing
Types and techniques
Single-chamber or dual-chamber
A single lead in the right ventricle suits people with permanent atrial fibrillation. A dual-chamber device adds a lead in the right atrium so the chambers beat in their natural order, and most people with heart block or sick sinus syndrome get one.
Biventricular pacing (CRT)
In some kinds of heart failure the lower chambers beat out of step. A third lead on the left side lets the device pace both together, which can ease breathlessness.
Leadless pacemakers
A capsule about 2.5 cm long is placed inside the heart through a vein in the groin, with no leads or chest pocket. It suits some people who need single-chamber pacing and is available only in some centres.
Preparing for surgery
- An ECG, blood tests (including potassium, thyroid, kidney function and clotting), a chest X-ray and usually an echocardiogram
- Tell us about blood thinners. Some are continued and some paused for a day or two, only on your cardiologist's advice
- Don't eat for about 6 hours before. Ask how to adjust insulin or diabetes tablets while fasting
- Tell the team which hand you use most. The device usually goes on the left or on your less-used side
- Mention any allergy to antibiotics or local anaesthetic, since you'll get an antibiotic dose beforehand
- Bring a loose, front-opening shirt or kurta so you don't have to lift your arm to dress
- Arrange help at home with lifting and chores for the first couple of weeks, and check that your insurance covers the device
The procedure, step by step
- 01
Getting ready
You're given an antibiotic and a mild sedative. The chest is cleaned and covered with sterile sheets, and the skin below the collarbone is numbed.
- 02
Making the pocket
A cut of about 5 cm is made below the collarbone, and a small pocket is shaped under the skin to hold the device.
- 03
Placing and testing the leads
Each lead is passed into a vein and guided into the heart on live X-ray, then fixed to the inner wall. The doctor checks that it senses and paces reliably, and you might notice a brief flutter.
- 04
Connecting and closing
The leads are attached to the pacemaker, which is tucked into the pocket, and the wound is closed with dissolving stitches or skin glue.
- 05
Checking afterwards
A chest X-ray confirms the lead positions and rules out a collapsed lung. Before you go home, the settings are checked with a programmer held over the skin.
Benefits and risks
Benefits
- Keeps your heart rate above a safe level, day and night
- Stops fainting and dizzy spells caused by a slow rhythm in most people
- More energy and less breathlessness when a slow heart was holding you back
- Stores rhythm data, so problems such as atrial fibrillation show up at routine checks
Possible risks
- Bruising or a collection of blood in the pocket, more likely on blood thinners
- A lead moving out of place, in roughly 1 to 2 in 100 people, which needs a second procedure
- Infection of the pocket or leads, in about 1 in 100, which usually means removing the whole system
- A collapsed lung (pneumothorax) from the vein puncture, in about 1 in 100 or fewer
- Rarely, a lead pierces the heart wall and fluid collects around the heart, which needs urgent drainage
Recovery timeline
The leads need a few weeks to settle into the heart wall, and most of the early rules are there to protect them.
- 01
Day 0 to 1
You rest with the arm on the pacemaker side kept still, sometimes in a sling. Simple painkillers ease the soreness, and most people go home the next day.
- 02
Weeks 1 to 2
Keep the dressing dry for 5 to 7 days and have the wound checked at 7 to 10 days. Don't raise that arm above shoulder height or lift anything heavy with it.
- 03
Weeks 2 to 6
Most people are back at desk work within 1 to 2 weeks. Driving is often allowed after about a week if you've had no blackouts, but check with your cardiologist. Ask before riding a two-wheeler too, since many cardiologists suggest waiting until the arm restrictions end.
- 04
After 6 weeks
You can return to full arm movement, yoga, swimming and most sports, while avoiding hard knocks to the device. Device checks follow at about 6 weeks and then every 6 to 12 months.
When to call your doctor
- Redness, swelling or discharge at the wound, or a fever
- Skin over the device turning thin, shiny or discoloured, or a swelling over it that keeps growing
- Dizziness, fainting, or a pulse below the rate your cardiologist set
- Hiccups that won't stop or twitching chest or stomach muscles, which can mean a lead has moved
- Breathlessness, chest pain, or a swollen arm on the pacemaker side
Call us on +91-8826000033 or come straight to our 24/7 emergency department.
Alternatives to surgery
Treating a reversible cause
If a beta-blocker, digoxin or even beta-blocker eye drops are slowing your heart, changing the medicine may be enough. Thyroid problems and high potassium can also slow the heart until they're treated.
Watching and monitoring
A slow pulse without symptoms, or mild first-degree heart block, often needs nothing more than a repeat ECG or Holter recording from time to time.
A defibrillator (ICD)
If the main danger is a fast, life-threatening rhythm, a defibrillator may be advised instead. It can pace too, but it can also deliver a shock to stop that rhythm.
Talk to our Cardiology team
Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.
This page explains Pacemaker Implantation in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.
Your care team
Pacemaker Implantation is led by our Cardiology team, with other departments stepping in at each stage of your care.
Leads your treatment
Cardiology Department
At Prakash Hospital, our Cardiology Department offers expert, round-the-clock care, providing timely diagnosis and advanced treatments for heart conditions to keep your heart healthy and strong.
What the department treats
Interventional Cardiology
Echocardiography
Cardiac Rehabilitation
Pacemaker Implantation
Angioplasty and Stenting
Heart Failure Management
Other departments involved
Emergency
Stabilises you if you arrive after a blackout or with a dangerously slow pulse, and calls in the cardiology team.
Diagnostic
Runs your blood tests and the chest X-ray that checks the lead positions afterwards.
General Medicine
Treats thyroid problems, diabetes and other conditions that affect your heart rhythm and wound healing.
Related procedures
Procedures often considered alongside Pacemaker Implantation, or that treat related conditions.
Holter Monitoring
A portable ECG worn for 24 to 48 hours to catch irregular heartbeats that come and go.
Echocardiography
An ultrasound of the heart that shows how well it pumps and how the valves work. Painless and radiation-free.
Stress Test (TMT)
An ECG recorded while you walk on a treadmill, to check for reduced blood flow to the heart during exercise.
Coronary Angiography
An X-ray dye test that maps blockages in the heart's arteries and guides the choice between medicines, stents and surgery.
Cardiac Catheterisation
Measures pressure and oxygen inside the heart and lungs through a thin tube, to guide valve and heart failure care.
More in Cardiology
Other procedures our Cardiology team performs.
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Frequently Asked Questions
Answers to common questions about Pacemaker Implantation at Prakash Hospital, Noida.
Can I use a mobile phone and household appliances?
Is it safe to go through airport security?
Can I have an MRI scan with a pacemaker?
What happens when the battery runs low?
Am I too old for a pacemaker?
Does insurance cover a pacemaker?
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