Pacemaker & ICD Implantation
A pacemaker is a small device implanted under the skin that uses fine leads to keep the heart beating at a healthy rate when its natural rhythm is too slow or unreliable. A related device, an implantable cardioverter-defibrillator (ICD), can also detect and correct dangerously fast rhythms. Both treat rhythm disorders that medication alone cannot manage and can be life-saving.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
When the heart's natural electrical system falters — beating too slowly, pausing, or failing to conduct signals properly — symptoms such as fainting, dizziness, breathlessness and severe tiredness can follow. A pacemaker continuously monitors the heart and delivers tiny, painless electrical impulses through one or more fine leads to keep the rate steady. An ICD does this too, but can additionally deliver a corrective shock if it detects a life-threatening fast rhythm.
The device, about the size of a small matchbox, is implanted just under the skin below the collarbone, with leads guided through a vein into the heart. The procedure is usually done under local anesthesia with light sedation and takes one to two hours. Modern devices are programmable, long-lasting and, in many cases, allow remote monitoring so the team can check the device without a clinic visit.
International patients are supported by a coordinator with a clear plan and a transparent, itemized cost estimate before travel, including the device, the procedure and follow-up. Our specialists can review your ECGs and reports remotely first to confirm which device is appropriate.
Who is a candidate?
- People with a heartbeat that is too slow (bradycardia) or pauses, causing symptoms
- Patients with heart block, where electrical signals are not conducted properly
- Those at risk of dangerously fast rhythms, who may benefit from an ICD
- People with certain types of heart failure who may benefit from a specialized pacing device
- Patients whose symptoms persist despite medication or who cannot rely on medication alone
- People seeking a second opinion on whether a device is appropriate for them
What happens
- 1
Assessment
ECGs, sometimes prolonged rhythm monitoring, and an echocardiogram confirm the rhythm problem and which device — pacemaker or ICD — is right for you.
- 2
Preparation
You are prepared for the procedure under local anesthesia with light sedation, and the area below the collarbone is numbed. The team explains the device and how it works.
- 3
Implantation
Through a small incision, the fine leads are guided through a vein into the heart and connected to the device, which is placed in a small pocket just under the skin and tested.
- 4
Short recovery
Your rhythm and the wound are monitored, and the device is programmed to your needs. Many patients go home the same day or after one night.
- 5
Follow-up and device checks
The device is checked periodically, often with remote monitoring. International patients receive a clear plan, wound-care guidance and instructions for ongoing checks after returning home.
Benefits
- Keeps the heartbeat steady when the natural rhythm is too slow or unreliable
- Relieves symptoms such as fainting, dizziness, breathlessness and tiredness
- An ICD can detect and correct dangerous fast rhythms, and can be life-saving
- Implanted under local anesthesia, often with a same-day or single-night stay
- Modern devices are long-lasting and many allow convenient remote monitoring
Risks & considerations
- Bruising, bleeding or infection at the device site
- Occasional movement of a lead, which may need repositioning
- Rare risk of fluid or air around the lung at the time of implantation
- The device battery eventually needs replacing in a smaller procedure after some years
- An ICD may, uncommonly, deliver a shock when it is not strictly needed
Conditions this treats
Where it is performed
This procedure is delivered by our Heart Center.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Pacemaker & ICD Implantation — frequently asked questions
A pacemaker keeps the heart beating at a healthy rate when it is too slow. An ICD does this too but can additionally deliver a corrective shock to stop a dangerously fast rhythm, so it is used when there is a risk of life-threatening arrhythmia.
Most people do not feel ordinary pacing, which delivers tiny, painless impulses. If an ICD ever delivers a shock to correct a dangerous rhythm, that can be felt briefly. Your team explains what to expect and how the device is monitored.
Yes. Many modern devices allow remote monitoring, so the team can check how the device and your heart rhythm are doing without an in-person visit, which is convenient for international patients returning home.
Yes. Send your ECGs, monitoring results and reports and our specialists provide an independent opinion remotely on whether a device is appropriate and which type, before you commit to travel.
Implantation often means a same-day or single-night stay plus a short period locally before flying — your coordinator confirms the plan. We provide a transparent, itemized estimate after reviewing your case, covering the device, the procedure and follow-up, rather than a fixed online price.
Related treatments
Considering pacemaker & icd implantation?
Share your reports for a medical second opinion and a transparent, itemized cost estimate — usually within 48 hours.