How is a pacemaker/ICD implanted?

Inserting a pacemaker is a simple operation. The wires are attached to the heart, and the pacemaker is placed in the abdomen (belly) or under the skin of the chest wall. Sometimes only one wire is attached to the heart. In other cases two wires are used. Many different models and brands of pacemakers exist. Some can sense when your child is active and increase the heart’s beating to keep up with exercise.

Pacemaker/ICD insertion is done in the hospital, either as a short-stay surgical procedure, or in the cardiac catheterization or electrophysiology laboratory. The child is given medication to help him/her relax during the procedure.

In older children and teenagers who receive a transvenous pacemaker, a small incision is made just under the collarbone. The pacemaker/ICD lead(s) is inserted into the heart through a blood vessel which runs under the collarbone. This procedure is usually performed in the catheterization laboratory.

In younger children, the pacemaker may be placed into the abdomen through a small incision. A second incision is made in the chest to visualize the heart. The lead(s) are guided to the heart, then placed on the heart’s surface. This procedure is usually performed in the operating room. Once the procedure has been completed, the child goes through a recovery period of several hours and often is allowed to go home the day after the procedure.