A permanent pacemaker is a battery operated device that is placed under the skin, usually in the left upper chest. Small wires connect the pacemaker to the heart. The device is approximately the size of a half-dollar and about 1/2 inch in thickness. The pacemaker is able to sense your heart’s rate and the time between beats. If your heartbeat is not regular or is too slow, the pacemaker sends a small amount of electricity to the heart to speed up the heart or make it beat more regularly. The insertion, which usually takes about 2 hours, is performed in a special room in our clinic.