| Individuals who require an internal artificial pacemaker | | | | used to guide the doctor as he advances the lead, |
| to regulate their heartbeat will need to undergo | | | | providing him with a detailed image of the interior of |
| pacemaker surgery to have the device implanted in | | | | the vein. Once the lead enters into the heart, it is |
| the body. The procedure is performed under local | | | | attached to the tissue so that the positioning of the |
| anesthetic, though patients are generally hospitalized | | | | lead may be tested. To test positioning, the surgeon |
| overnight for careful monitoring. Patients are given a | | | | sends small electrical signals down the lead and |
| mild sedative to keep them calm and relaxed but are | | | | evaluates the heart's response to the impulses. A |
| otherwise awake and alert throughout the procedure. | | | | suitable position is one that allows the full strength of |
| To insert the pacemaker, the surgeon makes a two to | | | | the signal to reach the heart, thereby signaling the |
| three inch incision just below the patient's collarbone. | | | | heart to contract and beat. It may be necessary to |
| An electrode lead is inserted into a nearby vein and | | | | reseat the lead within the vein several times before an |
| slowly advanced towards the heart. A fluoroscope is | | | | ideal position is achieved. |