Pacemakers and ICD’s are implanted in the hospital through an outpatient procedure. Patients are awake throughout the procedure. Using local anesthesia, the doctor will make a small incision in the upper chest and guide the lead wires through a vein and into your heart. The Cardiologist will then connect the lead wires to the pacemaker or ICD and then program the device settings. Finally, the device will be inserted beneath the skin and the incision in your chest will be closed.