My brother had his first O. put in when he was in his early 20's. He married at 16 years old, and when he had his pacemaker put in he was a young dad who was always exhausted and pale and thin. It was determined he had little. paricardium (the sac around the heart). He was a sickly child from about age 2 I guess..he is 9 years older than me so I don't remember his being "young".
His heart rate was so low (his resting heart rate was in the 20's!!!!). So a pacemaker it was to be. It was installed (this was over 25 years ago) normally with the electrodes attached to the paricardium...up near the left shoulder area of the chest. He was to go home from the hospital and early that day, was doing a slow walk down the hall with his pole(he was not a stationary person and HATED the hospital and Dr's), and this barrage of nurses came at him telling him they had been searching for him and he was not to be up and about. They said he needed to be prepped for surgery! He said NO WAY..I am going home tonight!
They said no...your recent scan showed the electrodes are no longer attached to anything. Apparently the little bit of paricardium he had was not enough to hold things in place. So they did a more major surgery that evening and installed the pacemaker down near his belly button (looked like he swallowed a bar of soap..they were much bigger then). They also had to stitch felt TO his heart to act as that buffer for the electrodes since the sac was not sufficient. It was a major deal and sorta new ground for the surgeons. Without a pacemaker he would die...you can't live with a heart rate of 20 bpm.
He is now 51 and is on his 4th pacemaker. He will be due for a new O. soonish. He is having some other minor health issues (back troubles, liver issues, etc) which he downplays like always and refuses to go in until its pretty extreme. He was also diagnosed with Graves Disease years ago and they killed his Thyroid and he takes a synthetic thyroid pill. That helped some with keeping weight on for overall health.
We are simply blessed he has stayed with us and that medical technology has made all of that possible. He lives a small and quiet life with his soul mate of 34 years, has 2 sons who both have sons of their own now. Most days, if he is not working, you can find him on a lake fishing with his wife right beside him...come Spring, Summer, Fall or Winter!