Pacemaker in Singapore — When It Is Needed & What to Expect

Written & reviewed by the BestDoctors.sg editorial team · Last updated 1 Sep 2026 · General information, not medical advice

At a glance

• A pacemaker is a small device implanted under the skin to treat a slow or unreliable heartbeat.
• It sends tiny electrical signals to keep the heart beating at an appropriate rate.
• It is commonly needed for a very slow heart rate causing dizziness, fainting or fatigue.
• Implantation is a minor procedure, and most people return to normal life.

What a pacemaker is

A pacemaker is a small, battery-powered device that is implanted under the skin, usually near the collarbone, to help the heart keep a steady, adequate rhythm. It watches the heart’s own electrical activity and, whenever the natural beat is too slow or pauses, it delivers a gentle electrical signal that prompts the heart to beat. These signals are painless and you cannot usually feel them. The device has two main parts: a sealed generator that holds the battery and the electronics, and one or more thin insulated wires, called leads, that carry the signals between the generator and the heart muscle.

Pacemakers come in different types, described here in plain terms. Some use a single lead, others use two, and a resynchronisation type uses an additional lead to help the two lower chambers of the heart beat together in certain people with weak heart muscle. A newer, self-contained leadless design sits entirely inside the heart and is suitable in selected cases. Your cardiologist or heart-rhythm specialist chooses the type that best fits your rhythm problem and your heart.

It helps to know that a pacemaker is not the same as an implantable defibrillator, or ICD. A pacemaker’s main job is to prevent the heart from going too slowly. An ICD is a related but different device that can also deliver a stronger shock to correct a dangerously fast or chaotic rhythm. Some devices combine both functions. Your specialist will explain which device suits your situation.

Why and when it is needed

A pacemaker is used when the heart beats too slowly or pauses in a way that causes symptoms or is unsafe. This often comes from problems with the heart’s own natural pacemaker, the sinus node, or with the electrical wiring that carries signals between the chambers, known as heart block. As the heart’s electrical system ages or is affected by disease, these signals can slow or become unreliable.

Symptoms of a slow or interrupted heartbeat include dizziness, light-headedness, unusual tiredness, breathlessness, and fainting or blackouts. Some people notice they can no longer keep up with everyday activity, while others have pauses picked up on a heart-rhythm recording before symptoms become severe. Because these symptoms have many possible causes, the decision to implant a pacemaker rests on careful assessment by a cardiologist or an electrophysiologist, often after monitoring the heart’s rhythm. Related devices, such as an implantable defibrillator or a resynchronisation device for heart failure, are used for different problems and are not interchangeable with a standard pacemaker.

How it is implanted

Implanting a pacemaker is a minor procedure rather than open-heart surgery. It is usually carried out in a specially equipped room using local anaesthetic to numb the skin, together with sedation to keep you relaxed and comfortable, so you are not fully asleep for most types. A small cut is made just below the collarbone. The lead or leads are guided through a nearby vein into the correct chambers of the heart, using X-ray imaging to position them accurately. The tips of the leads settle against the heart wall, and the other ends are connected to the generator, which is placed in a small pocket made under the skin or just beneath the muscle. The team tests the device before closing the cut. A leadless pacemaker, where used, is delivered through a vein in the leg and fixed directly inside the heart without a chest pocket or visible leads.

Preparing for the procedure

Before the procedure your care team will review your medical history, current medicines and any allergies. You may be asked to pause or adjust certain medicines, particularly blood thinners, for a period beforehand, but only on your doctor’s specific instructions, so tell them everything you take, including supplements. You will usually be asked not to eat or drink for a set time before the procedure. Tests such as blood tests, a tracing of the heart’s rhythm and sometimes a chest image may be arranged. Let the team know if you have any signs of infection, such as fever or a skin problem near the implant site, as the procedure may need to be delayed. Arrange for someone to accompany you home afterwards, as the sedation can leave you drowsy.

Recovery

Most people stay in hospital for a short time, often overnight, so the device and wound can be checked. You may have some soreness, swelling and bruising at the site for a few days, which usually settles. You will be shown how to care for the wound: keep it clean and dry, follow the advice you are given about dressings and bathing, and avoid rubbing or picking at it. A small firm bump under the skin where the device sits is normal and becomes less noticeable over time.

To let the leads settle securely, you will usually be advised to limit certain movements of the arm on the side of the implant for a period, in particular raising that arm above shoulder height and lifting anything heavy. Gentle everyday movement of the arm is encouraged so the shoulder does not stiffen. Your team will tell you when you can return to driving, work, exercise and other activities, as this depends on your job and your heart condition. Most people resume their normal routine before long. Attend all follow-up appointments, as the device settings are checked and fine-tuned after implantation.

Living with a pacemaker

Once you have recovered, a pacemaker is designed to fade into the background of daily life. You will have regular check-ups so the specialist can confirm the device is working well and monitor the battery, which lasts for a good number of years before it is replaced in a further minor procedure that changes the generator. Many pacemakers can also be checked remotely from home, reducing the number of clinic visits. You will be given a device identification card that records the make and model; carry it with you and show it to healthcare staff and at security checkpoints.

Most everyday electronics and household appliances are completely safe and will not affect your pacemaker, including mobile phones, computers, microwave ovens and kitchen equipment. Sensible precautions are worth remembering. Keep strong magnets away from the device, and it is reasonable to keep a mobile phone from resting directly over it. At airport and building security, show your device card; you can ask to be checked by hand rather than lingering in the archway. Tell doctors, dentists and hospital staff that you have a pacemaker before any procedure, as some treatments and scans need adjustments or precautions. An MRI scan needs particular care: many modern devices are MRI-conditional, but you must always check with your own doctor and the scanning team first. In Singapore, your follow-up may be with a cardiologist or electrophysiologist in the community or at a centre such as the National Heart Centre, and general heart-health information is available through HealthHub.

Risks and complications

A pacemaker implant is generally safe, but as with any procedure there are some risks. The more common ones are minor: bleeding, bruising or swelling around the pocket, and soreness at the site. Infection of the wound or the device can occur and is taken seriously, as it sometimes requires treatment or removal. Occasionally a lead can move out of position or stop working properly and may need to be repositioned or replaced. Rarely, passing a lead can cause a lung to partly deflate, or the heart wall can be irritated. Some people notice twitching of nearby muscle, or a persistent hiccup, if a lead is stimulating tissue outside the heart, which can usually be corrected by adjusting the device. Your team will discuss the risks that are relevant to you.

When to see a doctor

See a doctor for unexplained dizziness, fainting, or a very slow pulse with fatigue, so your heart rhythm can be assessed and a pacemaker considered if appropriate. After implantation, report swelling, redness or fever at the site, or a return of symptoms.

Seek urgent medical care if you faint or if dizziness, light-headedness or breathlessness returns, if you develop a fast or persistent hiccup or muscle twitching, or if you notice signs of a wound infection such as increasing redness, swelling, pain, discharge or fever. Call 995 immediately if you collapse or have chest pain.

Common questions

Is a pacemaker implant major surgery?

No. It is a minor procedure usually done under local anaesthesia with sedation, with a short recovery.

How long does a pacemaker battery last?

Typically several years; it is replaced with a minor procedure when the battery runs low.

Can I use a mobile phone with a pacemaker?

Yes. Everyday electronics are safe; simply avoid placing a phone directly over the device and keep away from strong magnetic fields.

Related guides

• Heart arrhythmias
• Fainting & blackouts
• Palpitations & atrial fibrillation
• Best cardiologists in Singapore
• Pacemaker & ICD Checks and Remote Monitoring (Singapore)
• Having a Pacemaker or ICD Fitted: What to Expect (Singapore)
• Living with a Pacemaker (Singapore)
• Deep Brain Stimulation
• EMG & Nerve Conduction Study

Sources

• Singapore Heart Foundation — pacemakers.
• National Heart Centre Singapore — cardiac devices.
• HealthHub Singapore — heart rhythm.

This article is for general information only and does not replace a consultation with a qualified doctor. If you have chest pain, breathlessness or fainting, seek urgent medical care.