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Permanent pacemaker that monitors the cardiac rhythm for dangerous arrhythmia's (abnormal beats) and has the ability to shock the heart back into a normal rhythm. AICD pacemaker is surgically implanted under skin to the left, or right, upper chest, or abdomen. 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.