The pacemaker implantation procedure involves accessing the vein in the groin area, which is thoroughly sterilised using antiseptic solution. Local anaesthesia is also applied to numb the site, providing relief for several hours after the procedure. Sedation is provided for comfort, or general anaesthetic provided in a safe manner with an anaesthetist.

Once the area is numbed, a wire is then threaded up to the heart through the vein, followed by a plastic tube over the wire, which is guided safely to the heart with the aid of an x-ray called an image intensifier. Contrast dye is used to enhance visibility, making it easier to guide the leadless pacemaker into the heart muscle. The pacemaker is then secured with small hooks to keep it safely in place within the heart wall.

To control any potential bleeding, special sutures are used during the pacemaker implantation procedure. It's normal to experience some pain once the effect of the local anesthesia wears off. However, pain relief medication such as paracetamol is typically enough to manage the discomfort. If you require additional pain relief, please inform the nursing staff. The length of the procedure will depend on various factors and can take several hours.

Following the pacemaker implantation procedure, you will see some dressings over the groin area. In some cases, a long suture may be visible, but it will be removed after a brief period.

After the procedure, a chest x-ray will be taken to ensure the pacemaker is correctly placed. The device will also be checked using a special computer called a programmer, which allows adjustments to be made to suit your individual requirements. If everything is in order and you are feeling well, you will be discharged home on a short course of antibiotics.

For the safety and well-being of patients, preventing infection during pacemaker implantations is of utmost importance. The utmost care is taken during the procedure to prevent this complication. However, it's essential that patients monitor their wound daily for any signs of infection, including fever, redness, heat, increased swelling, or new drainage. If you experience any of these symptoms, please report them to Dr. Hsieh immediately. Please refrain from tampering with the operating site yourself.

Unlike traditional pacemakers, leadless pacemakers do not require a period of limited arm movement. However, you should avoid squatting and heavy lifting for about a week after the procedure.

The Roads and Traffic Authority requires that patients refrain from driving for two weeks after a pacemaker implantation for a private vehicle and four weeks for a commercial vehicle. Patients will no longer be able to hold an unconditional license, but a conditional license is permissible with routine medical review.

Pacemaker checkups are necessary at two weeks and every few months thereafter. However, if you experience any unusual symptoms, such as difficulty breathing, dizziness, fainting, chest pain, hiccupping, or signs of infection, please report them to Dr. Hsieh.

After the implantation, you will receive a Medical Device ID card from the pacemaker company, which you should keep with you to alert medical and security personnel that you have an implanted device. Please note that the metal components of the device may set off airport security metal detector alarms and that airport security wands can temporarily affect the device. If security personnel use a handheld wand, ask them to perform the search quickly and avoid holding the wand over the device. If you have any doubts about equipment to avoid, please speak to your doctor or the device manufacturer for guidance. Most manufacturers have engineers who can determine whether the electrical field generated by a piece of equipment can interfere with the pacemaker.

While mobile phones can potentially interfere with the proper operation of the device, simple precautions, such as not carrying the phone directly over the pacemaker and holding it up to the ear that is farthest from the pacemaker, can minimise the risk.

Pacemaker implantation is a procedure with a relatively low risk of complications. The most common side effect is bruising at the site of the procedure, which occurs in less than 3% of cases, or up to 10% for patients on blood thinning medications. However, re-operation or blood transfusion due to bleeding is rare, occurring in less than 1% of cases. Other possible but uncommon complications include fluid or blood in the sac of the heart that may require drainage, infection, and dislodgement of the device. Finally, the device might be prevented from working if there is significant electromagnetic interference.