A permanent pacemaker is a self-contained device that is surgically implanted in a pocket under the patient's skin at the chest. One or two wires are placed in the vein at the top of the chest. Pacemakers allow the patient's heart to beat on its own but keep the heartbeat from falling below a preset rate. After the procedure, the patient is to stay in the hospital overnight. When going home, it's best to wear a button up shirt because the patient will have limited movement of the arm on the side the pacemaker was planted until the staples are removed. Your physician will discuss with you further about the amount of movement that is allowed.