How pacemakers are implanted

Hi there, you're gonna talk tell us about how a pacemaker is implanted? Yes so a pacemaker is almost always done as a straightforward day case procedure. So the patient comes in the morning, they have the procedure and then they go home the same day. And what happens during the procedure is that they are awake, they get local anesthetic to numb the skin and the muscle in the area where we're going to put the pacemaker in, often in the left shoulder. A little incision just under a couple of inches is made in the left shoulder and using this incision we place the leads through a vein all the way into the heart. It is connected to the battery and everything gets tucked into the pocket and stitched up and the patient then stays for four hours for monitoring observation as an x-ray after that monitoring period. If all was okay they go home with follow-up out as an outpatient. In terms of the risks of the procedure, there's about a 1-2% chance of bleeding or bruising or infection from where we make the cut in the skin and that's fairly standard and we will give antibiotics to try and reduce the risks of that happening. There is about a 1% chance of lung damage because it is quite close to the vein that we're trying to put the leads into and if that happens then the patient would often have to either stay for more observation or have a drain put in to relieve any air or blood around the lungs themselves. The leads can move. In the first few weeks, it's very important to make sure there's not too much movement of the shoulder and the arms, but there's probably about a 3% chance that the leads might displace or move in the first few weeks after the procedure itself. In terms of the serious complications, I often say it's 1 in 500, so 0.2% or less of something serious, so bleeding around the heart, requiring surgery, a stroke, a heart attack and less than 1 in 1,000 chance of death in the procedure. Okay, thank you very much.