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After the patient is anesthetized, or sedated and the area numbed, a needle is used to locate and enter the left subclavian arterery. A guide wire allows exchanging a plastic cannula for the needle. Two or more pacing wires are passed to the intended areas of the heart. Each wire is secured by means of a cork screw shaped needle which is twisted into the heart tissue. If the wire locations are proven to be effective by pacing the heart with an external signal generator, the surgeon will create a pocket between the skin and muscle layers about one inch away from where the wirers entered the artery. The wirers are tunneled to the pocket and then connected to the pacemaker. Once the pacer is interrogated wirelessly to enshure proper function, the pocket is sutured closed.

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