If the heart rate is too slow then a pacemaker may be implanted to speed up the heart rate. A pacemaker is a device that is implanted under the skin, usually on the left side below the collar bone.
The device is about the size of a cigarette lighter and is introduced through a skin incision that is 1-2 inches long. A number of wires (1 to 3) are passed under the collar bone and into a vein that takes them to the heart. These are gently attached to the heart muscle in the various chambers of the heart. The other ends of the wires are attached to the pacemaker before the skin is closed with sutures. By the end of the procedure there will be a small scar from the incision and a small swelling where the pacemaker is sitting under the skin. The procedure is undertaken using sedation and local anaesthetic so it is virtually painless. In general the procedure takes about 1 hour to perform, depending on the complexity of the pacing system required.