Patients with heart rate rhythm problems may undergo pacemaker implantation to install a device that can deliver an electrical impulse to restore a normal heartbeat when a too-slow rhythm is detected. Installation of a permanent pacemaker can be performed via a minimally invasive procedure with the patient under local anesthesia in a hospital operating room or cardiac catheterization lab unit. In many cases, the patient can go home within 24 hours. The procedure starts with the surgeon making a small incision in the upper chest. Two lead wires are next threaded through a vein and into the heart. Now the surgeon connects the leads to the device and programs the pacing generator before installing it under the skin just below the collarbone and closing the wound. Antibiotic medications are prescribed to reduce the risk of infection following the surgery.