Pacemaker - Mayo Clinic (2023)


A pacemaker is a small device that's placed (implanted) in the chest to help control the heartbeat. It's used to prevent the heart from beating too slowly. Implanting a pacemaker in the chest requires a surgical procedure.

A pacemaker is also called a cardiac pacing device.


Depending on your condition, you might have one of the following types of pacemakers.

  • Single chamber pacemaker. This type usually carries electrical impulses to the right ventricle of your heart.
  • Dual chamber pacemaker. This type carries electrical impulses to the right ventricle and the right atrium of your heart to help control the timing of contractions between the two chambers.
  • Biventricular pacemaker. Biventricular pacing, also called cardiac resynchronization therapy, is for people who have heart failure and heartbeat problems. This type of pacemaker stimulates both of the lower heart chambers (the right and left ventricles) to make the heart beat more efficiently.


  1. Cardiac resynchronization therapy

Why it's done

A pacemaker is implanted to help control your heartbeat. Your doctor may recommend a temporary pacemaker when you have a slow heartbeat (bradycardia) after a heart attack, surgery or medication overdose but your heartbeat is otherwise expected to recover. A pacemaker may be implanted permanently to correct a chronic slow or irregular heartbeat or to help treat heart failure.

The heart's conduction system

Pacemaker - Mayo Clinic (1)

(Video) Mayo Clinic Minute - What is a brain pacemaker?

The heart's conduction system

The heart's natural pacemaker — the sinus node — produces electrical signals that prompt your heart to beat.

How your heart beats

The heart is a muscular, fist-sized pump with four chambers, two on the left side and two on the right. The upper chambers (right and left atria) and the lower chambers (right and left ventricles) work with your heart's electrical system to keep your heart beating at an appropriate rate — usually 60 to 100 beats a minute for adults at rest.

Your heart's electrical system controls your heartbeat, beginning in a group of cells at the top of the heart (sinus node) and spreading to the bottom, causing it to contract and pump blood. Aging, heart muscle damage from a heart attack, some medications and certain genetic conditions can cause an irregular heart rhythm.


Pacemaker - Mayo Clinic (2)


A pacemaker is a device used to control an irregular heart rhythm. A pacemaker has flexible, insulated wires (leads) that are placed in one or more chambers of the heart. These wires deliver the electrical pulses to adjust the heart rate. Some newer pacemakers don't require leads.

What a pacemaker does

Pacemakers work only when needed. If your heartbeat is too slow (bradycardia), the pacemaker sends electrical signals to your heart to correct the beat.

Some newer pacemakers also have sensors that detect body motion or breathing rate and signal the devices to increase heart rate during exercise, as needed.

(Video) Ask Mayo Clinic Health System – Atrial Fibrillation and Pacemakers

A pacemaker has two parts:

  • Pulse generator. This small metal container houses a battery and the electrical circuitry that controls the rate of electrical pulses sent to the heart.
  • Leads (electrodes). One to three flexible, insulated wires are each placed in one or more chambers of the heart and deliver the electrical pulses to adjust the heart rate. However, some newer pacemakers don't require leads. These devices, called leadless pacemakers, are implanted directly into the heart muscle.

Request an Appointment at Mayo Clinic

From Mayo Clinic to your inbox

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Click here for an email preview.

(Video) 28 Pacemakers ICDs and Cardiac Resynchronization Therapy Mayo Clinic

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.


Complications related to pacemaker surgery or having a pacemaker are uncommon, but could include:

  • Infection near the site in the heart where the device is implanted
  • Swelling, bruising or bleeding at the pacemaker site, especially if you take blood thinners
  • Blood clots (thromboembolism) near the pacemaker site
  • Damage to blood vessels or nerves near the pacemaker
  • Collapsed lung (pneumothorax)
  • Blood in the space between the lung and chest wall (hemothorax)
  • Movement (shifting) of the device or leads, which could lead to cardiac perforation (rare)

How you prepare

Before your doctor decides if you need a pacemaker, you'll have several tests done to find the cause of your irregular heartbeat. Tests done before you get a pacemaker could include:

  • Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which displays the test results. An ECG can show if the heart is beating too fast, too slow or not at all.
  • Holter monitoring. A Holter monitor is a small, wearable device that keeps track of the heart's rhythm. Your doctor may want you to wear a Holter monitor for 1 to 2 days. During that time, the device records all of your heartbeats. Holter monitoring is especially useful in diagnosing heartbeat problems that occur at unpredictable times. Some personal devices, such as smartwatches, offer electrocardiogram monitoring. Ask your doctor if this is an option for you.
  • Echocardiogram. This noninvasive test uses sound waves to produce images of the heart's size, structure and motion.
  • Stress test. Some heart problems occur only during exercise. For a stress test, an electrocardiogram is taken before and immediately after walking on a treadmill or riding a stationary bike. Sometimes, a stress test is done along with echocardiography or nuclear imaging.

What you can expect

Before the procedure

You'll likely be awake during the surgery to implant the pacemaker, which typically takes a few hours. A specialist will insert an IV into your forearm or hand and give you a medication called a sedative to help you relax. Your chest is cleaned with special soap.

Most pacemaker implantations are done using local anesthesia to numb the area of the incisions. However, the amount of sedation needed for the procedure depends on your specific health conditions. You may be fully awake or lightly sedated, or you may be given general anesthesia (fully asleep).

During the procedure

One or more wires are inserted into a major vein under or near your collarbone and guided to your heart using X-ray images. One end of each wire is secured at the appropriate position in your heart, while the other end is attached to the pulse generator, which is usually implanted under the skin beneath your collarbone.

A leadless pacemaker is smaller and typically requires a less invasive surgery to implant the device. The pulse generator and other pacemaker parts are contained in a single capsule. The doctor inserts a flexible sheath (catheter) in a vein in the groin and then guides the single component pacemaker through the catheter to the proper position in the heart.

After the procedure

You'll likely stay in the hospital for a day after having a pacemaker implanted. Your pacemaker will be programmed to fit your heart rhythm needs. You'll need to arrange to have someone drive you home from the hospital.

Your doctor might recommend that you avoid vigorous exercise or heavy lifting for about a month. Avoid putting pressure on the area where the pacemaker was implanted. If you have pain in that area, ask your doctor about taking medicines available without a prescription, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Special precautions

It's unlikely that your pacemaker would stop working properly because of electrical interference. Still, you'll need to take a few precautions:

  • Cellphones. It's safe to talk on a cellphone, but keep your cellphone at least 6 inches (15 centimeters) away from your pacemaker. Don't keep your phone in a shirt pocket. When talking on your phone, hold it to the ear opposite the side where your pacemaker was implanted.
  • Security systems. Passing through an airport metal detector won't interfere with your pacemaker, although the metal in the pacemaker could sound the alarm. But avoid lingering near or leaning against a metal-detection system.

    To avoid potential problems, carry an ID card stating that you have a pacemaker.

  • Medical equipment. Make sure all your doctors and dentists know you have a pacemaker. Certain medical procedures, such as magnetic resonance imaging, CT scans, cancer radiation treatment, electrocautery to control bleeding during surgery, and shock wave lithotripsy to break up large kidney stones or gallstones could interfere with your pacemaker.
  • Power-generating equipment. Stand at least 2 feet (61 centimeters) from welding equipment, high-voltage transformers or motor-generator systems. If you work around such equipment, ask your doctor about arranging a test in your workplace to determine whether the equipment affects your pacemaker.

Devices that are unlikely to interfere with your pacemaker include microwave ovens, televisions and remote controls, radios, toasters, electric blankets, electric shavers, and electric drills.

(Video) Conventional versus leadless pacemakers


Having a pacemaker should improve symptoms caused by a slow heartbeat such as fatigue, lightheadedness and fainting. Because most of today's pacemakers automatically adjust the heart rate to match the level of physical activity, they may can allow you to resume a more active lifestyle.

Your doctor should check your pacemaker every 3 to 6 months. Tell your doctor if you gain weight, if your legs or ankles get puffy, or if you faint or get dizzy.

Most pacemakers can be checked by your doctor remotely, which means you don't have to go into the doctor's office. Your pacemaker sends information to your doctor, including your heart rate and rhythm, how your pacemaker is working, and how much battery life is left.

Your pacemaker's battery should last 5 to 15 years. When the battery stops working, you'll need surgery to replace it. The procedure to change your pacemaker's battery is often quicker and requires less recovery time than the procedure to implant your pacemaker.

Pacemakers and end-of-life issues

If you have a pacemaker and become terminally ill with a condition unrelated to your heart, such as cancer, it's possible that your pacemaker could prolong your life. Doctors and researchers vary in their opinions about turning off a pacemaker in end-of-life situations.

Talk to your doctor if you have a pacemaker and are concerned about turning it off. You may also want to talk to family members or another person designated to make medical decisions for you about what you'd like to do in end-of-life care situations.

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

By Mayo Clinic Staff

Dec. 02, 2021


What are the 3 primary problems that can occur with a pacemaker? ›

Problems with the pacemaker

A pacemaker can go wrong if: the lead gets pulled out of position. the battery of the pulse generator fails. the circuits that control the pacemaker are damaged after being exposed to strong magnetic fields.

What is the downside of a pacemaker? ›

Complications related to pacemaker surgery or having a pacemaker are uncommon, but could include: Infection near the site in the heart where the device is implanted. Swelling, bruising or bleeding at the pacemaker site, especially if you take blood thinners. Blood clots (thromboembolism) near the pacemaker site.

What are 4 things to be avoided if you have a pacemaker device? ›

Avoid devices that interfere with pacemakers
  • Cell phones. ...
  • Electronic cigarettes.
  • Headphones. ...
  • Household appliances, such as microwave ovens, major appliances, electric blankets, and heating pads are usually safe if they are working properly.
  • Metal detectors, such as those used for airport security.
Mar 24, 2022

What is a good resting heart rate with a pacemaker? ›

Key Findings. Without evidence-based guidance, the pacemaker lower rate limit is typically left at 60 beats per minute, which is much lower than the average adult resting heart rate of 71–79 beats per minute based on large cohorts.

What activities can you not do with a pacemaker? ›

You should avoid strenuous activities for around 4 to 6 weeks after having your pacemaker fitted. After this, you should be able to do most activities and sports. But if you play contact sports such as football or rugby, it's important to avoid collisions. You may want to wear a protective pad.

At what heart rate does a pacemaker kick in? ›

"Demand" signifies that the device will provide impulses only when needed. The pacemaker is individually programmed to maintain the patient's natural, intrinsic ventricular rate which usually falls between 50 and 70 beats per minute.

Does a pacemaker limit your life? ›

Most people with pacemakers live full and active lives, but there may be some restrictions to your lifestyle after pacemaker surgery.

Will I have more energy after pacemaker? ›

Pacemakers can improve your quality of life

Other studies found that pacemaker recipients have reported significantly more energy and overall feel happier in their everyday activities.

Should I be worried about getting a pacemaker? ›

The chance of most problems is low. The procedure to implant a pacemaker is safe, and most people do well afterward. Afterward, you will see your doctor regularly to get your pacemaker checked and to make sure you don't have any problems.

Can WIFI affect pacemakers? ›

A new study suggests this problem hasn't gone away. Magnetic wireless charging — a convenient feature of many smartphones and tech accessories — can interfere with pacemakers and defibrillators when people keep these devices too close to their chest, a new study has confirmed.

Why can't you raise your arm after pacemaker? ›

When you have a pacemaker fitted, it's important to be careful about moving your arms for the first six to eight weeks. Avoid heavy lifting, stretching and lifting your arms on the affected side above your head. This is because the leads need time to embed firmly in your heart.

Do fridge magnets affect pacemakers? ›

In ICDs in particular, magnets can activate a switch prohibiting the ICD from delivering vital signals such as lifesaving shocks. If you have an ICD or pacemaker, avoid close or prolonged contact with magnets or their magnetic fields. Keep magnets at least six inches from where your device is implanted.

How often should you see a cardiologist if you have a pacemaker? ›

The procedure is quick and painless. Patients with pacemakers will also need to see a cardiologist at least once a year.

What is the safest resting heart rate? ›

Laskowski, M.D. A normal resting heart rate for adults ranges from 60 to 100 beats per minute. Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate closer to 40 beats per minute.

Does hot weather affect a pacemaker? ›

Temperature increases cause a regular and reproducible increase in the frequency of generation of pacemaker potentials in most Aplysia neurons specialized for this type of activity which can only be explained as a direct stimulating effect of temperature upon the ionic mechanisms responsible for pacemaker potentials.

Can you get out of breath with a pacemaker? ›

Signs and Causes of Pacemaker Malfunction

You can tell if your pacemaker is malfunctioning if you are starting to experience symptoms of arrhythmia. You might have chest pain, difficulty breathing, dizziness, or lightheadedness.

Does a pacemaker affect blood pressure? ›

After implantation lowering of systolic pressures can be expected. Provisional care for overcoming this stage is indicated., In the majority of patients blood pressure rises after 3 to 5 months to pre-implantation values. Drug treatment must consider these changes of blood pressure behaviour.

What devices interfere with pacemakers? ›

American Heart Association cautions against keeping phones, other electronic devices near chest due to magnets
  • Apple AirPods Pro wireless charging case.
  • Microsoft Surface Pen.
  • Apple Pencil 2nd Generation.
Mar 2, 2022

What is considered a dangerously low heart rate? ›

If you have bradycardia, your heart beats fewer than 60 times a minute. Bradycardia can be a serious problem if the heart rate is very slow and the heart can't pump enough oxygen-rich blood to the body. If this happens, you may feel dizzy, very tired or weak, and short of breath.

What are the signs of needing a pacemaker? ›

How to tell if you need a pacemaker
  • Frequent fainting.
  • Inexplicable fatigue (you get enough sleep and stay healthy, yet always feel tired)
  • Inability to exercise, even lightly, without getting very winded.
  • Frequent dizziness or lightheadedness.
  • Heart palpitations or sudden, intense pounding in your chest (without exercise)

Are blood thinners needed with pacemaker? ›

18, 2016 (HealthDay News) -- People with an abnormal heart rhythm called atrial fibrillation typically take powerful blood thinners to prevent strokes. But, some patients who have implanted pacemakers or defibrillators may not always need the drugs, a new study suggests.

Why am I so tired with a pacemaker? ›

Pacemaker syndrome: some patients with VVI pacemakers, especially with sinoatrial (SA) rather than atrioventricular (AV) disease, will show retrograde ventriculoatrial (VA) conduction during ventricular pacing which can cause fatigue, dizziness and hypotension.

How will my life change after pacemaker? ›

Once you recover from the implantation surgery, none of the precautions you need to take are particularly burdensome, and you won't encounter most of them during your daily life. For the most part, once your pacemaker is implanted, you can go through your normal life without ever thinking about it.

Do people with pacemakers sleep more? ›

Generally improved sleep habit was reported in 50% patients of the pacemaker group and 15% patients of the ICD group (P=0.025). The patients with improved sleep habit in the pacemaker group reported longer sleep hours when compared to their pre-pacemaker baseline (7.13 vs. 6.48 hours, P=0.0001).

How long is bed rest after pacemaker? ›

The procedure usually takes about an hour, but it may take longer if you're having a biventricular pacemaker with 3 leads fitted or other heart surgery at the same time. You'll usually need to stay in hospital overnight and have a day's rest after the procedure.

Who is most likely to get a pacemaker? ›

The most common reason people get a pacemaker is their heart beats too slowly (called bradycardia), or it pauses, causing fainting spells or other symptoms. In some cases, the pacemaker may also be used to prevent or treat a heartbeat that is too fast (tachycardia) or irregular.

Are cell phones safe for pacemakers? ›

Based on current research, cell phones do not seem to pose a significant health problem for pacemaker wearers.

Can I use my cell phone if I have a pacemaker? ›

The FDA recommends that people keep their cellphones at least five to seven inches away from a pacemaker or ICD.

Do microwaves mess up pacemakers? ›

Can I use a cell phone or microwave oven if I have a pacemaker? Microwave ovens, electric blankets, remote controls for TV and other common household appliances won't affect your pacemaker.

Do you have to wear a sling after pacemaker? ›

After pacemaker/implantable cardioverter-defibrillator (pacemaker/ICD) implantation, patients are often required to immobilize the affected arm with a sling to minimize the risk of lead displacement.

How do you wash your hair after a pacemaker? ›

You may eat and wash/brush your hair with your affected arm.

When can I take a shower after a pacemaker implant? ›

Wound Care • Keep the incision dry for 7 days. DO NOT get the incision or bandage wet. You may have a sponge bath, but may NOT shower for 7 days or until after your first follow up visit.

Can you use a heating pad on your back if you have a pacemaker? ›

Should I avoid certain electrical devices if I have a pacemaker? Electric blankets, heating pads, and microwave ovens can be used and will not interfere with the function of your pacemaker. A cellphone should be used on the side opposite of where the pacemaker was implanted.

Can I use an electric toothbrush if I have a pacemaker? ›

Other appliances that contain a magnet include handheld hairdryers, older shavers with an electrical cord, large stereo speakers, electric toothbrushes and base chargers of ultrasonic toothbrushes. If you do use any of these, keep them 16cm (6in) away from your pacemaker.

What does it mean when your pacemaker vibrates? ›

Please consult your physician immediately if your device elicits any beeps or vibrations as this can signal issues with your battery or leads. Make sure to carry your device identification card at all times and update your physicians, dentists, and emergency personnel of your device implant.

What is an alarming resting heart rate? ›

You may want to start with a visit to your health care provider if your heart rate is consistently above 100 beats per minute or below 60 beats per minute (and you're not an athlete), or if you're also experiencing shortness of breath, fainting spells, lightheadedness or feeling fluttering or palpitations in your chest ...

What is a scary resting heart rate? ›

A person's heart rate or pulse should typically be between 60 and 100 beats per minute, but many factors can affect it. A rate below 60 is not necessarily dangerous, but a person whose heart rate is much higher than 100 may need medical attention.

At what heart rate should you go to the hospital? ›

If you're sitting down and feeling calm, your heart shouldn't beat more than about 100 times per minute. A heartbeat that's faster than this, also called tachycardia, is a reason to come to the emergency department and get checked out. We often see patients whose hearts are beating 160 beats per minute or more.

Should you go through a metal detector with a pacemaker? ›

You should not be screened by a walk-through metal detector if you have an internal medical device such as a pacemaker.

Does a pacemaker weaken heart muscle? ›

But activating the pacemaker function in the right side of a patient's heart may be throwing off synchronization with the left side, causing the heart to lose efficiency and deteriorate, said the report, which is to appear next Wednesday in The Journal of the American Medical Association.

What is the most common pacemaker malfunction? ›

Most common are the rate-related pseudomalfunctions. Rate changes in the presence of normal pacemaker function can occur because of magnet operation, timing variations (A-A vs V-V), upper-rate behavior (Wenckebach or 2:1 block), pacemaker-mediated tachycardia (PMT), or rate response.

What are the symptoms pacemaker lead problems? ›

The most common symptoms include chest pain, dyspnea, syncope, abdominal pain, diaphragm stimulation/hiccups secondary to phrenic nerve stimulation, and left chest muscle twitching, due to stimulation of the left pectoralis major by the lead tip.

What are the signs of a pacemaker malfunction? ›

Symptoms of pacemaker failure or malfunction include:
  • Dizziness or lightheadedness.
  • Fainting or loss of consciousness.
  • Feeling like your heart is fluttering (palpitations)
  • Hard time breathing.
  • Slow or fast heart rate, or a combination of both.
  • Constant twitching of muscles in the chest or abdomen.
  • Frequent hiccups.

How do you know if your pacemaker needs adjusting? ›

You can tell if your pacemaker is malfunctioning if you are starting to experience symptoms of arrhythmia. You might have chest pain, difficulty breathing, dizziness, or lightheadedness.

Can pacemaker wires come loose? ›

2.1 Lead dislodgement

Pacing lead displacement and dislodgement is a relatively common problem and can occur in 5-10 % of the patients (National Pacemaker and ICD database, 2001). Historically, the most common complication of transvenous pacing has been lead dislodgement.

What causes shortness of breath with pacemaker? ›

And so, the upper chambers beat against closed valves in the heart causing blood to be pushed backwards, causing a variety of things to happen: a sensation of pounding in the chest, shortness of breath, sometimes dizziness or lightheadedness because of low blood pressure, a sensation of shortness of breath, weakness ...

What is the most advanced pacemaker? ›

Unlike traditional pacemakers, leadless pacemakers are implanted directly into the heart through a minimally invasive catheter-based procedure and eliminate the need for cardiac leads.

Does pacemaker affect blood pressure? ›

After implantation lowering of systolic pressures can be expected. Provisional care for overcoming this stage is indicated., In the majority of patients blood pressure rises after 3 to 5 months to pre-implantation values. Drug treatment must consider these changes of blood pressure behaviour.

How easy is it to dislodge pacemaker leads? ›

Abstract. The rate of dislodgement of atrial pacing leads is ∼3%. To solve this problem, reoperation and repositioning of these leads is one of the solutions.

How many years does a pacemaker last? ›

Pacemakers can last from 5-15 years, depending on how often patients need them.

Can a doctor adjust a pacemaker? ›

Tell the medical team about any symptoms you feel. Your doctor will adjust the settings of your pacemaker after deciding how much electrical energy is needed to stimulate your heartbeat.

Can you still have irregular heartbeat with a pacemaker? ›

Pacemakers can be directly involved in initiating or sustaining multiple different forms of arrhythmia.

What heart rate is too low? ›

Overview. Bradycardia (brad-e-KAHR-dee-uh) is a slow heart rate. The hearts of adults at rest usually beat between 60 and 100 times a minute. If you have bradycardia, your heart beats fewer than 60 times a minute.


1. Pacemaker for Epilepsy - Mayo Clinic
(Mayo Clinic)
2. Bradycardia and Pacing - Mayo Clinic 2020
3. Cardiac Devices: What Is It and Where Should It Be?
(Mayo Clinic)
4. Mayo Clinic talks advancements in pacemakers, defibrillator technology
(ABC15 Arizona)
5. Outpacing Pacemaker and ICD Infections
(Mayo Clinic)
6. Pacemaker? You can stay in the game
(Mayo Clinic)
Top Articles
Latest Posts
Article information

Author: Laurine Ryan

Last Updated: 03/29/2023

Views: 5619

Rating: 4.7 / 5 (77 voted)

Reviews: 84% of readers found this page helpful

Author information

Name: Laurine Ryan

Birthday: 1994-12-23

Address: Suite 751 871 Lissette Throughway, West Kittie, NH 41603

Phone: +2366831109631

Job: Sales Producer

Hobby: Creative writing, Motor sports, Do it yourself, Skateboarding, Coffee roasting, Calligraphy, Stand-up comedy

Introduction: My name is Laurine Ryan, I am a adorable, fair, graceful, spotless, gorgeous, homely, cooperative person who loves writing and wants to share my knowledge and understanding with you.