Former premier Silvio Berlusconi is in the USA for a medical check-up and possibly to undergo pacemaker surgery.

These arrangements have been made public by Northern League leader and Berlusconi's personal friend and ally Umberto Bossi, who announced the news from a stage at Piazza Castello in Milan during a political rally.

Until now Berlusconi and his spokesperson Paolo Bonaiuti had denied the rumours. When asked a few days ago if he was planning a trip to Houston, reputed to have the best cardiologists in the world, Berlusconi quipped, "Houston? If anything I'll go to Las Vegas!"

After Bossi spilled the beans, however, Bonaiuti confirmed that "President Berlusconi is in the United States for some medical checks." Italian cardiologists have criticised this "intercontinental transfer" to receive medical treatment.

It is believed that Berlusconi is either in Houston or Cleveland, where Andrea Natale, a leading pacemaker expert, works.