The patient undergoes a thorough evaluation, including medical history review, physical examination, and diagnostic tests such as electrocardiography (ECG) and echocardiography.

Anesthesia or sedation is administered to ensure patient comfort during the procedure. Local anesthesia is also applied to the implantation site.

A small incision is made, usually near the collarbone, and a vein (often the subclavian vein) is accessed using a needle and guidewire.

One or more leads (thin, insulated wires) are advanced through the vein and positioned in the appropriate chambers of the heart, typically the right atrium and/or right ventricle.