"Permanent" pacemaker, surgically implanted under skin to the left, or right, upper chest. Connected to one, or two, pacing lead wires. Pacing lead wire(s) are inserted into a vein and advanced to the heart. The pacing lead wire(s) are then placed in the upper, and/or lower, chamber(s) of the right side of the heart. Patients can come to the hospital as an "out-patient" however; a new implantation will require the patient to be observed overnight. Patients with an existing permanent pacemaker that needs a new battery can come to the hospital as an outpatient and will usually go home the same day. Length of time for the procedure varies but is usually approximately 1 1/2 hours, start to finish. Usually the patient may eat and drink after the procedure, when awake.