{"id":23963,"date":"2026-07-31T14:10:55","date_gmt":"2026-07-31T07:10:55","guid":{"rendered":"https:\/\/abdiwaluyo.com\/?p=23963"},"modified":"2026-08-05T08:34:59","modified_gmt":"2026-08-05T01:34:59","slug":"pacemaker-implantation-worlds-smallest-pacemaker","status":"publish","type":"post","link":"https:\/\/abdiwaluyo.com\/en\/coe\/pacemaker-implantation-worlds-smallest-pacemaker\/","title":{"rendered":"Pacemaker Implantation (World&#8217;s Smallest Pacemaker)"},"content":{"rendered":"<p><em>By: <\/em><em>RS Abdi Waluyo<\/em><\/p>\n<hr \/>\n<h2 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"rzkdgm\" data-start=\"133\" data-end=\"144\">Overview<\/h2>\n<h3 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"rzkdgm\" data-start=\"133\" data-end=\"144\">What is Pacemaker Implantation?<\/h3>\n<p data-start=\"183\" data-end=\"427\"><strong data-start=\"183\" data-end=\"209\">Pacemaker Implantation<\/strong> is a minimally invasive cardiac procedure used to treat abnormal heart rhythms (<strong data-start=\"290\" data-end=\"305\">arrhythmias<\/strong>), particularly conditions where the heart beats too slowly (<strong data-start=\"366\" data-end=\"381\">bradycardia<\/strong>) or fails to maintain an adequate heart rate.<\/p>\n<p data-start=\"429\" data-end=\"799\">A pacemaker is a small electronic device placed under the skin, usually beneath the collarbone, that monitors the heart\u2019s electrical activity and delivers electrical impulses when needed to help maintain a normal heart rhythm. The device consists of a pulse generator and one or more leads that are positioned inside the heart chambers to deliver electrical stimulation.<\/p>\n<p data-start=\"801\" data-end=\"1107\">When the heart\u2019s natural electrical system does not function properly, patients may experience symptoms such as fatigue, dizziness, fainting, shortness of breath, or reduced exercise capacity. A pacemaker helps restore a more effective heart rhythm, improving symptoms and supporting better heart function.<\/p>\n<p data-start=\"1109\" data-end=\"1442\">At <strong data-start=\"1112\" data-end=\"1130\">RS Abdi Waluyo<\/strong>, pacemaker implantation is performed by experienced electrophysiologists and cardiologists using advanced cardiac imaging and monitoring technology. The procedure is supported by a multidisciplinary Heart Team approach to ensure accurate diagnosis, optimal device selection, and personalized treatment planning.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"27h1z\" data-start=\"1175\" data-end=\"1199\">Why is Pacemaker Implantation performed?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"1497\" data-end=\"1564\">Your cardiologist may recommend pacemaker implantation if you have:<\/p>\n<ul data-start=\"1566\" data-end=\"2236\">\n<li data-section-id=\"m9svb2\" data-start=\"1566\" data-end=\"1621\">Slow heart rhythm (<strong data-start=\"1587\" data-end=\"1602\">bradycardia<\/strong>) causing symptoms.<\/li>\n<li data-section-id=\"1tw4anc\" data-start=\"1622\" data-end=\"1708\">Sick sinus syndrome, where the heart\u2019s natural pacemaker does not function properly.<\/li>\n<li data-section-id=\"sedwjg\" data-start=\"1709\" data-end=\"1826\">Heart block, where electrical signals between the upper and lower chambers of the heart are delayed or interrupted.<\/li>\n<li data-section-id=\"13kf3v0\" data-start=\"1827\" data-end=\"1895\">Recurrent fainting (<strong data-start=\"1849\" data-end=\"1860\">syncope<\/strong>) related to abnormal heart rhythm.<\/li>\n<li data-section-id=\"1ow9xde\" data-start=\"1896\" data-end=\"1976\">Fatigue, dizziness, or reduced exercise tolerance caused by a slow heart rate.<\/li>\n<li data-section-id=\"c7ndet\" data-start=\"1977\" data-end=\"2045\">Certain heart rhythm problems after cardiac procedures or surgery.<\/li>\n<li data-section-id=\"c7vufg\" data-start=\"2046\" data-end=\"2141\">Need for cardiac resynchronization therapy (<strong data-start=\"2092\" data-end=\"2099\">CRT<\/strong>) in selected patients with heart failure.<\/li>\n<li data-section-id=\"6lwdmi\" data-start=\"2142\" data-end=\"2236\">Prevention of dangerous rhythm complications in patients with specific conduction disorders.<\/li>\n<\/ul>\n<p data-start=\"2238\" data-end=\"2430\">The goal of pacemaker implantation is to maintain an appropriate heart rhythm, improve symptoms, enhance quality of life, and reduce complications associated with slow or irregular heartbeats.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"kmzivm\" data-start=\"2088\" data-end=\"2102\">Test Details<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"2469\" data-end=\"2630\">Pacemaker implantation is a safe and minimally invasive procedure performed in a specialized cardiac procedure room or <strong data-start=\"2588\" data-end=\"2629\">Catheterization Laboratory (Cath Lab)<\/strong>.<\/p>\n<p data-start=\"2632\" data-end=\"2653\">Before the procedure:<\/p>\n<ul data-start=\"2655\" data-end=\"3039\">\n<li data-section-id=\"wckp8r\" data-start=\"2655\" data-end=\"2743\">Your cardiologist will review your medical history, symptoms, and current medications.<\/li>\n<li data-section-id=\"13x04x4\" data-start=\"2744\" data-end=\"2814\">Electrocardiography (<strong data-start=\"2767\" data-end=\"2774\">ECG<\/strong>) and echocardiography may be performed.<\/li>\n<li data-section-id=\"1w3kxgf\" data-start=\"2815\" data-end=\"2866\">Blood tests may be required before the procedure.<\/li>\n<li data-section-id=\"wxxeki\" data-start=\"2867\" data-end=\"2943\">Chest X-ray or additional cardiac imaging may be performed when indicated.<\/li>\n<li data-section-id=\"nssgwp\" data-start=\"2944\" data-end=\"3039\">Your doctor will determine the most appropriate pacemaker type based on your heart condition.<\/li>\n<\/ul>\n<p data-start=\"3041\" data-end=\"3088\">Before the procedure, you may be instructed to:<\/p>\n<ul data-start=\"3090\" data-end=\"3398\">\n<li data-section-id=\"1p64lp5\" data-start=\"3090\" data-end=\"3136\">Fast for several hours before the procedure.<\/li>\n<li data-section-id=\"ylbkyj\" data-start=\"3137\" data-end=\"3245\">Temporarily adjust certain medications, including blood thinners, according to your doctor\u2019s instructions.<\/li>\n<li data-section-id=\"1kpfe6c\" data-start=\"3246\" data-end=\"3331\">Inform your doctor about allergies, especially to medications or medical materials.<\/li>\n<li data-section-id=\"ts1dhp\" data-start=\"3332\" data-end=\"3398\">Inform your doctor about any existing implanted medical devices.<\/li>\n<\/ul>\n<p data-start=\"3400\" data-end=\"3534\">Pacemaker implantation generally takes <strong data-start=\"3439\" data-end=\"3455\">1 to 2 hours<\/strong>, depending on the complexity of the procedure and the type of device required.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"ja1mi6\" data-start=\"3253\" data-end=\"3284\">What Happens During the Test?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"3583\" data-end=\"3613\">During pacemaker implantation:<\/p>\n<ul data-start=\"3615\" data-end=\"4193\">\n<li data-section-id=\"6xuuga\" data-start=\"3615\" data-end=\"3714\">Local anesthesia is administered near the collarbone area to ensure comfort during the procedure.<\/li>\n<li data-section-id=\"ceplfs\" data-start=\"3715\" data-end=\"3765\">A small incision is made beneath the collarbone.<\/li>\n<li data-section-id=\"1l0e6g7\" data-start=\"3766\" data-end=\"3845\">A thin lead wire is guided through a vein into the heart using X-ray imaging.<\/li>\n<li data-section-id=\"5r87n4\" data-start=\"3846\" data-end=\"3956\">The lead is positioned inside the appropriate heart chamber and tested to ensure proper electrical function.<\/li>\n<li data-section-id=\"4k1iiw\" data-start=\"3957\" data-end=\"4037\">The pacemaker generator is connected to the lead(s) and placed under the skin.<\/li>\n<li data-section-id=\"117a8ke\" data-start=\"4038\" data-end=\"4127\">The device settings are programmed according to your heart condition and medical needs.<\/li>\n<li data-section-id=\"1awb6qv\" data-start=\"4128\" data-end=\"4193\">The incision is closed after confirming proper device function.<\/li>\n<\/ul>\n<p data-start=\"4195\" data-end=\"4319\">Throughout the procedure, your heart rhythm, blood pressure, oxygen level, and overall condition are continuously monitored.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"4rki7b\" data-start=\"4208\" data-end=\"4246\">What Should I Expect After the Test?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"4375\" data-end=\"4404\">After pacemaker implantation:<\/p>\n<ul data-start=\"4406\" data-end=\"4934\">\n<li data-section-id=\"1skftih\" data-start=\"4406\" data-end=\"4469\">You will be monitored in the recovery area for several hours.<\/li>\n<li data-section-id=\"9gyxr0\" data-start=\"4470\" data-end=\"4562\">Most patients can go home the same day or the following day, depending on their condition.<\/li>\n<li data-section-id=\"pn1afl\" data-start=\"4563\" data-end=\"4622\">Your pacemaker function will be checked before discharge.<\/li>\n<li data-section-id=\"onpxfx\" data-start=\"4623\" data-end=\"4719\">Your doctor will provide instructions regarding wound care, medication, and physical activity.<\/li>\n<li data-section-id=\"1acix0p\" data-start=\"4720\" data-end=\"4841\">You may need to limit certain arm movements on the side of the pacemaker implantation during the early recovery period.<\/li>\n<li data-section-id=\"1tu4bjt\" data-start=\"4842\" data-end=\"4934\">Regular follow-up appointments are required to monitor device function and battery status.<\/li>\n<\/ul>\n<p data-start=\"4936\" data-end=\"5013\">Most patients can gradually return to normal daily activities after recovery.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"ip0x1o\" data-start=\"4657\" data-end=\"4678\">What Are the Risks?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"5047\" data-end=\"5164\">Pacemaker implantation is considered a safe procedure with a high success rate. However, potential risks may include:<\/p>\n<ul data-start=\"5166\" data-end=\"5492\">\n<li data-section-id=\"13ixgdz\" data-start=\"5166\" data-end=\"5214\">Bleeding or bruising at the implantation site.<\/li>\n<li data-section-id=\"w24gpy\" data-start=\"5215\" data-end=\"5255\">Infection around the pacemaker pocket.<\/li>\n<li data-section-id=\"1xpsz39\" data-start=\"5256\" data-end=\"5278\">Blood vessel injury.<\/li>\n<li data-section-id=\"1z0s5ff\" data-start=\"5279\" data-end=\"5323\">Lead displacement requiring repositioning.<\/li>\n<li data-section-id=\"1dnjk3i\" data-start=\"5324\" data-end=\"5392\">Air leakage around the lung (<strong data-start=\"5355\" data-end=\"5371\">pneumothorax<\/strong>), which is uncommon.<\/li>\n<li data-section-id=\"gr87bf\" data-start=\"5393\" data-end=\"5421\">Heart rhythm disturbances.<\/li>\n<li data-section-id=\"nfb68g\" data-start=\"5422\" data-end=\"5458\">Device malfunction, although rare.<\/li>\n<li data-section-id=\"1t3spv4\" data-start=\"5459\" data-end=\"5492\">Need for additional procedures.<\/li>\n<\/ul>\n<p data-start=\"5494\" data-end=\"5587\">Your healthcare team carefully monitors you throughout the procedure to minimize these risks.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"fzlcum\" data-start=\"5220\" data-end=\"5243\">Results and Follow-Up<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"5623\" data-end=\"5675\">After implantation, your cardiologist will evaluate:<\/p>\n<ul data-start=\"5677\" data-end=\"5898\">\n<li data-section-id=\"779q21\" data-start=\"5677\" data-end=\"5705\">Proper pacemaker function.<\/li>\n<li data-section-id=\"124uq46\" data-start=\"5706\" data-end=\"5733\">Heart rhythm improvement.<\/li>\n<li data-section-id=\"yo03bb\" data-start=\"5734\" data-end=\"5799\">Resolution of symptoms such as dizziness, fainting, or fatigue.<\/li>\n<li data-section-id=\"1f49ojh\" data-start=\"5800\" data-end=\"5857\">Appropriate pacing support according to your condition.<\/li>\n<li data-section-id=\"14vmjec\" data-start=\"5858\" data-end=\"5898\">Battery status and device performance.<\/li>\n<\/ul>\n<p data-start=\"5900\" data-end=\"5934\">Follow-up care typically includes:<\/p>\n<ul data-start=\"5936\" data-end=\"6157\">\n<li data-section-id=\"1ts2r5t\" data-start=\"5936\" data-end=\"5971\">Regular cardiology consultations.<\/li>\n<li data-section-id=\"r3sobm\" data-start=\"5972\" data-end=\"6026\">Pacemaker device checks and programming adjustments.<\/li>\n<li data-section-id=\"1rz4gk1\" data-start=\"6027\" data-end=\"6063\">Medication management when needed.<\/li>\n<li data-section-id=\"1ppoc4r\" data-start=\"6064\" data-end=\"6095\">Monitoring of heart function.<\/li>\n<li data-section-id=\"r3qq4a\" data-start=\"6096\" data-end=\"6157\">Lifestyle recommendations to support cardiovascular health.<\/li>\n<\/ul>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"aoh1un\" data-start=\"5907\" data-end=\"5940\">When Will I Receive My Results?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"6203\" data-end=\"6302\">Your cardiologist can usually confirm successful pacemaker function immediately after implantation.<\/p>\n<p data-start=\"6304\" data-end=\"6361\">Before discharge, you will receive information regarding:<\/p>\n<ul data-start=\"6363\" data-end=\"6532\">\n<li data-section-id=\"1ym9nsb\" data-start=\"6363\" data-end=\"6403\">Pacemaker performance and programming.<\/li>\n<li data-section-id=\"z65apz\" data-start=\"6404\" data-end=\"6447\">Heart rhythm response after implantation.<\/li>\n<li data-section-id=\"7xnf66\" data-start=\"6448\" data-end=\"6472\">Recovery instructions.<\/li>\n<li data-section-id=\"1ofhyvl\" data-start=\"6473\" data-end=\"6500\">Activity recommendations.<\/li>\n<li data-section-id=\"1yv7g9f\" data-start=\"6501\" data-end=\"6532\">Long-term follow-up schedule.<\/li>\n<\/ul>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"1rrdh8\" data-start=\"6297\" data-end=\"6352\">If the Results Are Abnormal, What Are the Next Steps?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"6608\" data-end=\"6688\">If further evaluation or treatment is required, your cardiologist may recommend:<\/p>\n<ul data-start=\"6690\" data-end=\"7004\">\n<li data-section-id=\"hie3lb\" data-start=\"6690\" data-end=\"6716\">Pacemaker reprogramming.<\/li>\n<li data-section-id=\"rla2u9\" data-start=\"6717\" data-end=\"6748\">Additional rhythm monitoring.<\/li>\n<li data-section-id=\"kc7y0v\" data-start=\"6749\" data-end=\"6780\">Electrophysiology evaluation.<\/li>\n<li data-section-id=\"34er5e\" data-start=\"6781\" data-end=\"6805\">Medication adjustment.<\/li>\n<li data-section-id=\"w8exxp\" data-start=\"6806\" data-end=\"6868\">Lead revision or replacement if device-related issues occur.<\/li>\n<li data-section-id=\"1ygrwkj\" data-start=\"6869\" data-end=\"6951\">Cardiac resynchronization therapy (<strong data-start=\"6906\" data-end=\"6913\">CRT<\/strong>) for selected heart failure patients.<\/li>\n<li data-section-id=\"wt1384\" data-start=\"6952\" data-end=\"7004\">Other rhythm management procedures when indicated.<\/li>\n<\/ul>\n<p data-start=\"7006\" data-end=\"7137\">Treatment recommendations will be individualized based on your heart rhythm condition, symptoms, and overall cardiovascular health.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"1ha4cze\" data-start=\"6997\" data-end=\"7028\">When Should I Call My Doctor?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"7181\" data-end=\"7231\">Contact your doctor immediately if you experience:<\/p>\n<ul data-start=\"7233\" data-end=\"7510\">\n<li data-section-id=\"193d95p\" data-start=\"7233\" data-end=\"7307\">Redness, swelling, warmth, or drainage from the pacemaker incision site.<\/li>\n<li data-section-id=\"b3a563\" data-start=\"7308\" data-end=\"7338\">Fever or signs of infection.<\/li>\n<li data-section-id=\"69x3ax\" data-start=\"7339\" data-end=\"7352\">Chest pain.<\/li>\n<li data-section-id=\"1w3mm8u\" data-start=\"7353\" data-end=\"7375\">Shortness of breath.<\/li>\n<li data-section-id=\"39ww68\" data-start=\"7376\" data-end=\"7400\">Dizziness or fainting.<\/li>\n<li data-section-id=\"117jrfh\" data-start=\"7401\" data-end=\"7427\">Persistent palpitations.<\/li>\n<li data-section-id=\"1dn0uo5\" data-start=\"7428\" data-end=\"7477\">Swelling of the arm or area near the pacemaker.<\/li>\n<li data-section-id=\"hn5vox\" data-start=\"7478\" data-end=\"7510\">Any new or worsening symptoms.<\/li>\n<\/ul>\n<p data-start=\"7512\" data-end=\"7677\">Seek emergency medical attention immediately if you experience severe chest pain, difficulty breathing, fainting, or symptoms suggestive of a heart attack or stroke.<\/p>\n<hr \/>\n<h1 class=\"PDq2pG_selectionAnchorContainer\" data-section-id=\"8d8c5p\" data-start=\"7433\" data-end=\"7470\">Why Choose RS Abdi Waluyo for Pacemaker Implantation?<\/h1>\n<p class=\"PDq2pG_selectionAnchorContainer\" data-start=\"7745\" data-end=\"7969\">At <strong data-start=\"7748\" data-end=\"7766\">RS Abdi Waluyo<\/strong>, our cardiac rhythm management program combines advanced technology, experienced specialists, and multidisciplinary expertise to provide comprehensive treatment for patients with heart rhythm disorders.<\/p>\n<p data-start=\"7971\" data-end=\"8000\">Our Pacemaker Program offers:<\/p>\n<ul data-start=\"8002\" data-end=\"8792\">\n<li data-section-id=\"1s996uv\" data-start=\"8002\" data-end=\"8098\">Advanced pacemaker implantation supported by modern cardiac monitoring and imaging technology.<\/li>\n<li data-section-id=\"c7g29l\" data-start=\"8099\" data-end=\"8191\">Experienced electrophysiologists and cardiologists specializing in heart rhythm disorders.<\/li>\n<li data-section-id=\"1oa1ny4\" data-start=\"8192\" data-end=\"8294\">Comprehensive evaluation to determine the most appropriate device based on each patient\u2019s condition.<\/li>\n<li data-section-id=\"zlbv3a\" data-start=\"8295\" data-end=\"8433\">Advanced treatment options, including conventional pacemakers and cardiac resynchronization therapy (<strong data-start=\"8398\" data-end=\"8405\">CRT<\/strong>) when clinically indicated.<\/li>\n<li data-section-id=\"1au9pib\" data-start=\"8434\" data-end=\"8538\">Integrated cardiac care, from diagnosis and device implantation to long-term monitoring and follow-up.<\/li>\n<li data-section-id=\"1y1nf9u\" data-start=\"8539\" data-end=\"8699\">Multidisciplinary Heart Team collaboration involving cardiologists, electrophysiologists, cardiac surgeons, imaging specialists, and supporting medical teams.<\/li>\n<li data-section-id=\"19wh11w\" data-start=\"8700\" data-end=\"8792\">Patient-centered care focused on safety, precision, comfort, and improved quality of life.<\/li>\n<\/ul>\n<p data-start=\"8794\" data-end=\"9086\" data-is-last-node=\"\" data-is-only-node=\"\">By combining advanced cardiac rhythm technology, experienced specialists, and comprehensive follow-up care, <strong data-start=\"8902\" data-end=\"8920\">RS Abdi Waluyo<\/strong> provides high-quality pacemaker implantation services to help patients achieve better heart rhythm control, symptom improvement, and long-term cardiovascular health.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By: RS Abdi Waluyo Overview What is Pacemaker Implantation? Pacemaker Implantation is a minimally invasive cardiac procedure used to treat abnormal heart rhythms (arrhythmias), particularly conditions where the heart beats too slowly (bradycardia) or fails to maintain an adequate heart rate. A pacemaker is a small electronic device placed under the skin, usually beneath the <a href=\"https:\/\/abdiwaluyo.com\/en\/coe\/pacemaker-implantation-worlds-smallest-pacemaker\/\" class=\"more-link\">&#8230;<span class=\"screen-reader-text\">  Pacemaker Implantation (World&#8217;s Smallest Pacemaker)<\/span><\/a><\/p>\n","protected":false},"author":19,"featured_media":24013,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[57],"tags":[],"class_list":["post-23963","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-coe"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pacemaker Implantation (World&#039;s Smallest Pacemaker) - Abdi Waluyo Hospital<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/abdiwaluyo.com\/en\/coe\/pacemaker-implantation-worlds-smallest-pacemaker\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pacemaker Implantation (World&#039;s Smallest Pacemaker) - Abdi Waluyo Hospital\" \/>\n<meta property=\"og:description\" content=\"By: RS Abdi Waluyo Overview What is Pacemaker Implantation? Pacemaker Implantation is a minimally invasive cardiac procedure used to treat abnormal heart rhythms (arrhythmias), particularly conditions where the heart beats too slowly (bradycardia) or fails to maintain an adequate heart rate. A pacemaker is a small electronic device placed under the skin, usually beneath the ... 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