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Cardiolucent

Procedure

Pacemaker Implantation

Reliable, lifelong protection against slow heart rhythms

A pacemaker is a small device placed under the skin of the upper chest with one or more thin leads that connect to the heart. It continuously monitors rhythm and delivers gentle electrical impulses any time the heart beats too slowly, restoring a normal rate. Pacemakers are highly reliable, last roughly a decade per battery, and are among the most successful technologies in modern medicine. The procedure is performed at Cedars-Sinai by an electrophysiologist with whom Dr. Kedan coordinates closely.

What's Included

  • Pre-procedure evaluation and informed consent
  • Local anesthesia and conscious sedation
  • Implantation of generator and lead(s) under fluoroscopic guidance
  • Single-, dual-, or biventricular configuration as indicated
  • Intra-procedural testing of sensing and pacing thresholds
  • Overnight observation in most cases
  • Long-term remote monitoring with Dr. Kedan's coordination

How It's Performed

The procedure is performed at Cedars-Sinai in an electrophysiology lab. Under local anesthesia and conscious sedation, a small pocket is created under the skin of the upper chest below the collarbone, and one or more thin leads are guided through a vein into the heart under live X-ray imaging. The pulse generator is connected and tucked into the pocket. Total procedure time is typically 1 to 2 hours.

How to Prepare

  • Nothing to eat or drink for 8 hours before the procedure.
  • Take or hold blood thinners exactly as the procedural team directs.
  • Arrange a driver and overnight support at home.
  • Bring a complete medication list and any prior device cards.
  • Plan to wear loose, button-front shirts in the first weeks after the implant.

What to Expect After

Most patients stay overnight and go home the next day. Avoid raising the arm on the implant side above shoulder level for 4 to 6 weeks while leads heal in place. Heavy lifting is restricted for the same period. Dr. Kedan coordinates lifelong device follow-up — typically remote interrogation every 3 months and an in-person check annually — and adjusts settings over time to match your needs.

Indications

  • Symptomatic sinus node dysfunction (slow heart rate from the heart's natural pacemaker)
  • Second- or third-degree atrioventricular (AV) block
  • Chronotropic incompetence — inability to raise heart rate with activity
  • Bradycardia related to required medications
  • Pauses and syncope from rhythm slowing
  • Atrial fibrillation with slow ventricular response
  • Selected heart failure patients requiring biventricular pacing (CRT)

Common Questions

Frequently Asked Questions

What is a pacemaker?
A pacemaker is a small device implanted under the skin of the upper chest with one or more thin leads connecting to the heart. It continuously monitors your rhythm and delivers a small electrical impulse any time the heart beats too slowly — restoring a normal rate and eliminating symptoms like fatigue, lightheadedness, and fainting.
How is it different from an ICD?
A pacemaker primarily prevents the heart from going too slow. An ICD does that too but is also designed to deliver shocks to terminate dangerously fast rhythms. The two devices look similar from the outside but serve different primary purposes.
Where is the procedure done?
At Cedars-Sinai in an electrophysiology lab. Dr. Kedan coordinates the procedure with the electrophysiology team and remains involved in pre- and post-procedural care and long-term follow-up.
How long does it take?
Typically 1 to 2 hours. Most patients stay overnight and go home the next day.
Is it painful?
You receive local anesthesia and conscious sedation, so you should feel little to nothing during the procedure. The implant site is sore for several days afterward and easily managed with simple pain medication.
How do I prepare?
Fast for 8 hours before the procedure, take or hold blood thinners exactly as the procedural team directs, arrange a driver and overnight support, and bring a complete medication list.
What are the risks?
Risks include bleeding at the implant site, pneumothorax (collapsed lung from lead placement), infection, lead dislodgment, and very rarely a perforation requiring drainage. Most procedures are uneventful, and risks are reviewed in detail during informed consent.
How long does the battery last?
Typically 8 to 12 years depending on how much pacing is required. Generator changes — replacing the battery while keeping the existing leads — are a much simpler procedure than the initial implant.
What does follow-up look like?
Dr. Kedan coordinates lifelong device monitoring — typically remote interrogation every 3 months and an in-person check annually. Settings are adjusted over time as your needs change.
How do I schedule one?
Pacemaker implantation follows a thorough clinical evaluation. Call Cardiolucent at (310) 304-5555 to begin the conversation.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.