Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
A pacemaker is a device that is surgically implanted under the skin of the chest to mimic the electrical pulses that regulate heartbeats. Pacemaker surgery may be anoutpatient procedure or an inpatient procedurebased on your health and the cause of the rhythm disorder.
A pacemaker is used for long-term correction of a too-slow heartbeat (arrhythmia) or temporarily, such as after open-heart surgery. Implanting a pacemaker is considered a minimally invasive procedure.
This article discusses pacemaker implantation surgery, its purpose, and some of the risks and contraindications. It also goes over what to expect before, during, and after the procedure.
Peter Dazeley / Getty Images
What Is Pacemaker Surgery?
Pacemaker surgery is done to implant a pacemaker device.
Pacemaker surgery is used to treat a wide range of heart rhythm disorders. While typically performed in adults withheart disease, it is also used in children withcongenital heart conditions.
Most pacemakers are implanted usinglocal anesthesia, although you may also receiveintravenous (IV) sedationto help you relax.
What Is Arrhythmia?
Types
There are different types of pacemakers used to treat different types of arrhythmia. They are broadly categorized as follows:
There are also combination devices calledautomated implantable cardioverter-defibrillators (AICDs)that contain both a pacemaker and adefibrillator. In addition to regulating heart rhythm, AICDs deliver a jolt of electricity when needed to correct ventriculartachycardiaorventricular fibrillation(irregular heartbeats).
Most pacemakers last for about six to 10 years before they need to be replaced.AICDs often need replacement earlier—between three and six years, on average.
The Heart’s Chambers and Valves
Contraindications
Pacemakers are generally contraindicated if a heart rhythm disorder is identified during a cardiac evaluation but is not causing symptoms.
Potential Risks
In addition to the generalrisks of surgeryandanesthesia, pacemaker surgery presents its own risks and concerns. Although the surgery is considered to be low risk, around 3% of pacemaker recipients will experience some form of complication ranging from mild and treatable to potentially life-threatening.
Risks and complications of pacemaker implantation surgery include:
According to a 2019 study in theJournal of Clinical Medicine,pneumothorax and lead dislodgment were the two most common complications, occurring at a rate of 3.87% and 8.39%, respectively.
Severe complications, like stroke, occur in less than 2% of cases and usually in people with pre-existing risk factors.
Purpose of Pacemaker Surgery
Having a pacemaker implanted often helps you feel better so you can return to your daily routine without symptoms like dizziness,palpitations, breathlessness, difficulty exercising, and fainting.
Pacemaker implantation can improve your quality of life, though it is important to maintain communication with your healthcare team after implantation and follow up with your provider as required.
1:42Click Play to Learn All About Pacemaker Surgery
1:42
Click Play to Learn All About Pacemaker Surgery
In addition, your life expectancy may improve. Research has found that life expectancy in people with pacemakers who do not have significant underlying medical conditions (e.g., heart failure, atrial fibrillation, or other serious non-cardiac conditions) approaches that of the general population.
The indications for a pacemaker have increased in recent decades. According to the American College of Cardiology (ACC), the American Heart Association (AHA), and the Heart Rhythm Society (HRS), pacemakers are appropriate for the following conditions and medical needs:
With that said, being diagnosed with any of these conditions does not mean you will get (or should get) a pacemaker.
To determine the need, a healthcare provider will perform tests to decide if the condition is Class I (in which the benefits outweigh the risks), Class IIa (benefits may outweigh the risks), Class IIb (benefits are equal to or greater than the risks), or Class III (risks may outweigh the benefits).
To classify the severity, pre-operative tests may be performed, including:
How Implanted Cardioverter Defibrillators (ICD) Restore Heart Rhythm
Pacemaker implantation is a common surgery but one that requires preparation. Once a pacemaker has been recommended, you will meet with acardiologistorgeneral surgeonto discuss the procedure, how to prepare, and what to expect.
What Is a Cardiologist?
Location
Pacemaker surgery takes place in an operating room or cardiac catheterization lab of a hospital or specialized surgical center.
The room will be equipped with an ECG machine, amechanical ventilator, and a “crash cart” used in the event of a cardiac emergency. It will also have a fluoroscope—a machine that uses X-rays to produce live images of the heart to guide the placement of the pacemaker leads.
What to Wear
If the surgery is performed on an outpatient basis, you should wear clothes you can get into/out of easily. You will be asked to change into a hospital gown and to remove any hairpieces, eyewear, dentures, hearing aids, and tongue or lip piercings.
If the surgery requires an overnight hospital stay for observation purposes, bring only what you need for the stay, including toiletries, daily medications, a comfortable robe and slippers, your cell phone and charger, and an extra pair of socks and underwear. Leave any valuables at home.
What to Pack for the Hospital
Food and Drink
You will need to stop eating at midnight the night before your surgery. On the day of the surgery, you are allowed a few sips of water to take your morning pills, if applicable.
Medications
Medications that promote bleeding must be avoided before pacemaker surgery. Some may need to be stopped a day or so beforehand, while others may need to be avoided for a week or more beforeandafter surgery. These include:
To avoid complications and interactions, advise your healthcare provider about any drugs you are taking, whether they are prescription, over-the-counter, nutritional, herbal, and recreational.
What to Bring
You will need to bring a driver’s license or some other form of government ID to register at hospital admissions. You will also be asked for your insurance card. Although most facilities will bill for their services, some may ask for the upfront payment ofcopay or coinsurancecosts.
Call in advance to ensure that the facility accepts your insurance and that all providers, including theanesthesiologist, arein-network providers. If upfront payment is requested, ask what form of payment the office accepts.
You will also need to bring someone with you to drive you home. Even if only local anesthesia is used, your arm will be in a sling for 24 to 48 hours after the procedure. This, along with the aftereffects of IV sedation, makes driving hazardous.
What to Expect on the Day of Surgery
You’ll meet an anesthesiologist and an operating nurse who are part of the team accompanying the cardiologist or general surgeon performing the procedure.
Before the Surgery
When you arrive at the hospital, you will be asked to register, fill out a medical history form, and sign a consent form stating that you understand the aims and risks of the procedure.
After this, you are led to the back to change into a hospital gown. A nurse will record your height, weight, andvital signs, and perform a panel of blood tests to ensure there are no conditions that contraindicate surgery.
Other pre-operative procedures include:
An Overview of Surgery
During the Surgery
Once you are prepped, you are wheeled into the operating room and placed on a table in an upward-facing (supine) position under the fluoroscope.
Local anesthesiais given to numb the surgical site. A sedative may also be delivered through the IV line to help you relax and place you in a “twilight sleep” (referred to asmonitored anesthesia care (MAC). To reduce the risk of infection, an intravenousantibioticwill also be delivered.
Once theanesthesiatakes effect, the chest will be swabbed with an antibacterial solution and the body covered with sterile drapes.
An incision is then made on the chest near the shoulder (usually the left) to place the pacemaker. Using the fluoroscope, the healthcare provider will implant one or more leads into the appropriate chambers of the heart. The end of leads are secured.
Once the pacemaker is properly positioned under the skin, the device is tested. The incision is closed withsuturesor adhesive strips, and a sling is placed on your arm to immobilize the arm and shoulder and prevent lead dislodgment.
From start to finish, pacemaker surgery takes around 30 minutes. The implantation of an AICD can take longer (usually around an hour).
What Are External Pacemakers Used For?
After Surgery
After surgery, you are wheeled to the recovery room. Most people wake up from anesthesia with MAC in 10 minutes or so, although the effects of the drugs can persist for four to six hours.When you awaken, the nurse will monitor your condition and may offer you a light snack and drink.
It is not unusual to feel some pain and discomfort around the implantation site immediately after surgery. Your healthcare provider will provide medications to help control these symptoms at home. If you feel sick from the anesthesia, the nurse may be able to provide you withanti-nausea medications.
Once your vital signs are stable, you will either be wheeled to your hospital room for overnight observation or allowed to leave in the care of a friend or family member if you are an outpatient.
15 Things You Can’t Do With a Pacemaker
As the local anesthesia begins to wear off, you are likely to feel more pain and pressure around the wound. This can be controlled with over-the-counterTylenol (acetaminophen)or a short course of prescription opioid painkillers.
In addition to painkillers, your healthcare provider may prescribe a course of oral antibiotics (for less than 10 days) to help prevent infection.
Bruising in the area where the pacemaker was placed is normal and common. The device will create an area of raised skin on the chest that can be felt and/or seen; this will be permanent.
With proper care and wound management, most people who have undergone pacemaker surgery are able to return to normal activity within four weeks.
Healing
It is important to keep the wound as dry as possible for the first five days until the wound is sufficiently healed. Avoid bathing or showering for the first day. Thereafter, take a bath instead of a shower or ask your practitioner for a disposable adhesive patch (called AquaGard) to create a watertight barrier when showering.
When to Call a Healthcare ProviderCall your practitioner or surgeon immediately if you experience any of the following after pacemaker surgery:Increasing redness, pain, and swelling at the implantation siteHigh fever (100.5 degrees F) with chillsA yellowish-green discharge from the wound, often foul-smellingAn opening wound (incision dehiscence)
When to Call a Healthcare Provider
Call your practitioner or surgeon immediately if you experience any of the following after pacemaker surgery:Increasing redness, pain, and swelling at the implantation siteHigh fever (100.5 degrees F) with chillsA yellowish-green discharge from the wound, often foul-smellingAn opening wound (incision dehiscence)
Call your practitioner or surgeon immediately if you experience any of the following after pacemaker surgery:
After seven to 10 days, you will need to see your healthcare provider to have the stitches removed and the wound checked.
Physical Activity
Upon your return home, you should move as little as possible, in part to prevent lead dislodgment but also to reduce pain. Even after the stitches are out, you will need to avoid raising the arm nearest to the pacemaker for the next one to two weeks.
Do not drive until the healthcare provider gives you the OK, and avoid strenuous exercises or the lifting of heavy objects. You will be given the go-ahead to resume sex once your wound site heals (around one to two weeks).
Once you’re cleared to get back to your normal routine, it is important to keep physically active to improve blood circulation and maintain the normalrange of motionin the shoulder. Speak with your cardiologist about an appropriate exercise plan or ask for a referral to a qualifiedphysical therapist.
High-impact sports should be permanently avoided as heavy blows can damage the device.
Once you have healed, you may notice a dramatic improvement in your energy levels and stamina. The pacemaker helps your heart work efficiently, reducing fatigue and allowing you to be more active.
One of the keys to sustaining good health is routine visits with your cardiologist. Most healthcare providers will want to schedule the first follow-up within six months of the implantation and then every six to 12 months thereafter, depending on the type of pacemaker used.
This helps ensure that the pacemaker is working properly and that adjustments are made when needed to prolong the life of the device.
Your cardiologist may also ask you to check and write down your pulse at home.This is done to ensure your pacemaker is working well and keeping your heart rate within an appropriate range.
Be sure you are clear on when and how to get in touch with your practitioner after taking your pulse.
How Long Do Pacemaker Batteries Last?Pacemaker batteries last between five and 10 years. After this time, you will need surgery to replace the pulse generator. In most cases, this procedure can be done on an outpatient basis.
How Long Do Pacemaker Batteries Last?
Pacemaker batteries last between five and 10 years. After this time, you will need surgery to replace the pulse generator. In most cases, this procedure can be done on an outpatient basis.
Lifestyle Adjustments
After your pacemaker is implanted, you will need to avoid magnetic fields, as they can interfere with the function of the device.
For example, refrain from placing small electronics, such as your cell phone, in your breast pocket and going through metal detectors.
You’ll receive a medical ID card that provides details about your pacemaker including the type, manufacturer, date of implant, and the healthcare provider’s name who implanted it. You should carry this with you at all times.
Alternatively, consider purchasing acustom medical ID braceletthat has the pacemaker information engraved on it.
This is helpful not only in emergency care situations in which you cannot convey your medical history, but also in situations that may expose you to magnetic fields, such as:
Medical ID Cards to Identify Metal Implants for the TSA
Summary
Pacemaker implantation is a minimally invasive procedure to implant a pacemaker device, which can help treat a number of conditions that cause problems with heart rhythm. A pacemaker can help improve symptoms like palpitations, breathlessness, and trouble exercising.
The pacemaker is implanted during a procedure involving local anesthesia. You may also receive a sedative. The surgeon will make a small incision on your chest near your shoulder and implant one or more leads into your heart. Depending on your condition and overall health, you may be able to go home on the same day, or you may be kept in the hospital overnight for observation.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kotsakou M, Kioumis I, Lazaridis G, et al.Pacemaker insertion.Ann Transl Med.2015;3(3):42. doi:10.3978/j.issn.2305-5839.2015.02.06American Heart Association.Implantable cardioverter defibrillator (ICD).De Vries LM, Leening MJG, Dijk WA, Hooijschuur CAM, Stricker BHC, Van Hemel NM.Trends in service time of pacemakers in the Netherlands: a long-term nationwide follow-up study.Neth Heart J. 2017;25(10):581-91. doi:10.1007/s12471-017-1024-xMadhavan M, Waks JW, Friedman PA, et al.Outcomes after implantable cardioverter-defibrillator generator replacement for primary prevention of sudden cardiac death.Circ Arrhythm Electrophysiol. 2016;9(3):e003283. doi:10.1161/CIRCEP.115.003283Sidhu S, Marine JE.Evaluating and managing bradycardia.Trends Cardiovasc Med. 2020;30(5):265-272. doi:10.1016/j.tcm.2019.07.001Ranasinghe I, Labrosciano C, Horton D, et al.Institutional variation in quality of cardiovascular implantable electronic device implantation: A cohort study.Ann Intern Med. 2019;171(5):309-17. doi:10.7326/M18-2810Carrión-Camacho MR, Marín-León I, Molina-Doñoro JM, González-López JR.Safety of permanent pacemaker implantation: A prospective study. J Clin Med. 2019;8(1):35. doi:10.3390/jcm8010035Edwards SJ, Karner C, Trevor N, et al.Description of health problem.Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2015.Polikandrioti M.Patient perceptions and quality of life in pacemaker recipients.J Innov Card Rhythm Manag. 2021;12(11):4769-4779. doi:10.19102/icrm.2021.121103Bradshaw PJ, Stobie P, Knuiman MW.Life expectancy after implantation of a first cardiac permanent pacemaker (1995-2008): A population-based study.Int J Cardiol. 2015;190:42-6. doi:10.1016/j.ijcard.2015.04.099.Kusumoto FM, Schoenfeld MH, Barrett C, et al.2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Circulation. 2019;140(8):e382-e482. doi:10.1161/CIR.0000000000000628Bansal S, Chakraborty P.Cardiac pacemakers: Indications, choices and follow up.Oo ZT, Bhavsar D, Aung TPP, Ayala-Rodriguez CE, Kyaw H.Exercise stress test-induced atrioventricular dissociation with syncope.Ochsner J. 2021;21(3):319-324. doi:10.31486/toj.20.0134Alturki A, Proietti R, Birnie DH, Essebag V.Management of antithrombotic therapy during cardiac implantable device surgery.J Arrhythm. 2016;32(3):163-9. doi:10.1016/j.joa.2015.12.003Sohn HM, Ryu JH.Monitored anesthesia care in and outside the operating room.Korean J Anesthesiol. 2016;69(4):319-26. doi:10.4097/kjae.2016.69.4.319Biocic M, Vidosevic D, Boric M, et al.Anesthesia and perioperative pain management during cardiac electronic device implantation.J Pain Res. 2017;10:927-32. doi:10.2147/JPR.S132241University of Michigan Medicine.Arrhythmias and sexual activity.American Heart Association.Living with your pacemaker.American Heart Association.Pacemaker identification - wallet card.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kotsakou M, Kioumis I, Lazaridis G, et al.Pacemaker insertion.Ann Transl Med.2015;3(3):42. doi:10.3978/j.issn.2305-5839.2015.02.06American Heart Association.Implantable cardioverter defibrillator (ICD).De Vries LM, Leening MJG, Dijk WA, Hooijschuur CAM, Stricker BHC, Van Hemel NM.Trends in service time of pacemakers in the Netherlands: a long-term nationwide follow-up study.Neth Heart J. 2017;25(10):581-91. doi:10.1007/s12471-017-1024-xMadhavan M, Waks JW, Friedman PA, et al.Outcomes after implantable cardioverter-defibrillator generator replacement for primary prevention of sudden cardiac death.Circ Arrhythm Electrophysiol. 2016;9(3):e003283. doi:10.1161/CIRCEP.115.003283Sidhu S, Marine JE.Evaluating and managing bradycardia.Trends Cardiovasc Med. 2020;30(5):265-272. doi:10.1016/j.tcm.2019.07.001Ranasinghe I, Labrosciano C, Horton D, et al.Institutional variation in quality of cardiovascular implantable electronic device implantation: A cohort study.Ann Intern Med. 2019;171(5):309-17. doi:10.7326/M18-2810Carrión-Camacho MR, Marín-León I, Molina-Doñoro JM, González-López JR.Safety of permanent pacemaker implantation: A prospective study. J Clin Med. 2019;8(1):35. doi:10.3390/jcm8010035Edwards SJ, Karner C, Trevor N, et al.Description of health problem.Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2015.Polikandrioti M.Patient perceptions and quality of life in pacemaker recipients.J Innov Card Rhythm Manag. 2021;12(11):4769-4779. doi:10.19102/icrm.2021.121103Bradshaw PJ, Stobie P, Knuiman MW.Life expectancy after implantation of a first cardiac permanent pacemaker (1995-2008): A population-based study.Int J Cardiol. 2015;190:42-6. doi:10.1016/j.ijcard.2015.04.099.Kusumoto FM, Schoenfeld MH, Barrett C, et al.2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Circulation. 2019;140(8):e382-e482. doi:10.1161/CIR.0000000000000628Bansal S, Chakraborty P.Cardiac pacemakers: Indications, choices and follow up.Oo ZT, Bhavsar D, Aung TPP, Ayala-Rodriguez CE, Kyaw H.Exercise stress test-induced atrioventricular dissociation with syncope.Ochsner J. 2021;21(3):319-324. doi:10.31486/toj.20.0134Alturki A, Proietti R, Birnie DH, Essebag V.Management of antithrombotic therapy during cardiac implantable device surgery.J Arrhythm. 2016;32(3):163-9. doi:10.1016/j.joa.2015.12.003Sohn HM, Ryu JH.Monitored anesthesia care in and outside the operating room.Korean J Anesthesiol. 2016;69(4):319-26. doi:10.4097/kjae.2016.69.4.319Biocic M, Vidosevic D, Boric M, et al.Anesthesia and perioperative pain management during cardiac electronic device implantation.J Pain Res. 2017;10:927-32. doi:10.2147/JPR.S132241University of Michigan Medicine.Arrhythmias and sexual activity.American Heart Association.Living with your pacemaker.American Heart Association.Pacemaker identification - wallet card.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kotsakou M, Kioumis I, Lazaridis G, et al.Pacemaker insertion.Ann Transl Med.2015;3(3):42. doi:10.3978/j.issn.2305-5839.2015.02.06American Heart Association.Implantable cardioverter defibrillator (ICD).De Vries LM, Leening MJG, Dijk WA, Hooijschuur CAM, Stricker BHC, Van Hemel NM.Trends in service time of pacemakers in the Netherlands: a long-term nationwide follow-up study.Neth Heart J. 2017;25(10):581-91. doi:10.1007/s12471-017-1024-xMadhavan M, Waks JW, Friedman PA, et al.Outcomes after implantable cardioverter-defibrillator generator replacement for primary prevention of sudden cardiac death.Circ Arrhythm Electrophysiol. 2016;9(3):e003283. doi:10.1161/CIRCEP.115.003283Sidhu S, Marine JE.Evaluating and managing bradycardia.Trends Cardiovasc Med. 2020;30(5):265-272. doi:10.1016/j.tcm.2019.07.001Ranasinghe I, Labrosciano C, Horton D, et al.Institutional variation in quality of cardiovascular implantable electronic device implantation: A cohort study.Ann Intern Med. 2019;171(5):309-17. doi:10.7326/M18-2810Carrión-Camacho MR, Marín-León I, Molina-Doñoro JM, González-López JR.Safety of permanent pacemaker implantation: A prospective study. J Clin Med. 2019;8(1):35. doi:10.3390/jcm8010035Edwards SJ, Karner C, Trevor N, et al.Description of health problem.Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2015.Polikandrioti M.Patient perceptions and quality of life in pacemaker recipients.J Innov Card Rhythm Manag. 2021;12(11):4769-4779. doi:10.19102/icrm.2021.121103Bradshaw PJ, Stobie P, Knuiman MW.Life expectancy after implantation of a first cardiac permanent pacemaker (1995-2008): A population-based study.Int J Cardiol. 2015;190:42-6. doi:10.1016/j.ijcard.2015.04.099.Kusumoto FM, Schoenfeld MH, Barrett C, et al.2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Circulation. 2019;140(8):e382-e482. doi:10.1161/CIR.0000000000000628Bansal S, Chakraborty P.Cardiac pacemakers: Indications, choices and follow up.Oo ZT, Bhavsar D, Aung TPP, Ayala-Rodriguez CE, Kyaw H.Exercise stress test-induced atrioventricular dissociation with syncope.Ochsner J. 2021;21(3):319-324. doi:10.31486/toj.20.0134Alturki A, Proietti R, Birnie DH, Essebag V.Management of antithrombotic therapy during cardiac implantable device surgery.J Arrhythm. 2016;32(3):163-9. doi:10.1016/j.joa.2015.12.003Sohn HM, Ryu JH.Monitored anesthesia care in and outside the operating room.Korean J Anesthesiol. 2016;69(4):319-26. doi:10.4097/kjae.2016.69.4.319Biocic M, Vidosevic D, Boric M, et al.Anesthesia and perioperative pain management during cardiac electronic device implantation.J Pain Res. 2017;10:927-32. doi:10.2147/JPR.S132241University of Michigan Medicine.Arrhythmias and sexual activity.American Heart Association.Living with your pacemaker.American Heart Association.Pacemaker identification - wallet card.
Kotsakou M, Kioumis I, Lazaridis G, et al.Pacemaker insertion.Ann Transl Med.2015;3(3):42. doi:10.3978/j.issn.2305-5839.2015.02.06
American Heart Association.Implantable cardioverter defibrillator (ICD).
De Vries LM, Leening MJG, Dijk WA, Hooijschuur CAM, Stricker BHC, Van Hemel NM.Trends in service time of pacemakers in the Netherlands: a long-term nationwide follow-up study.Neth Heart J. 2017;25(10):581-91. doi:10.1007/s12471-017-1024-x
Madhavan M, Waks JW, Friedman PA, et al.Outcomes after implantable cardioverter-defibrillator generator replacement for primary prevention of sudden cardiac death.Circ Arrhythm Electrophysiol. 2016;9(3):e003283. doi:10.1161/CIRCEP.115.003283
Sidhu S, Marine JE.Evaluating and managing bradycardia.Trends Cardiovasc Med. 2020;30(5):265-272. doi:10.1016/j.tcm.2019.07.001
Ranasinghe I, Labrosciano C, Horton D, et al.Institutional variation in quality of cardiovascular implantable electronic device implantation: A cohort study.Ann Intern Med. 2019;171(5):309-17. doi:10.7326/M18-2810
Carrión-Camacho MR, Marín-León I, Molina-Doñoro JM, González-López JR.Safety of permanent pacemaker implantation: A prospective study. J Clin Med. 2019;8(1):35. doi:10.3390/jcm8010035
Edwards SJ, Karner C, Trevor N, et al.Description of health problem.Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2015.
Polikandrioti M.Patient perceptions and quality of life in pacemaker recipients.J Innov Card Rhythm Manag. 2021;12(11):4769-4779. doi:10.19102/icrm.2021.121103
Bradshaw PJ, Stobie P, Knuiman MW.Life expectancy after implantation of a first cardiac permanent pacemaker (1995-2008): A population-based study.Int J Cardiol. 2015;190:42-6. doi:10.1016/j.ijcard.2015.04.099.
Kusumoto FM, Schoenfeld MH, Barrett C, et al.2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Circulation. 2019;140(8):e382-e482. doi:10.1161/CIR.0000000000000628
Bansal S, Chakraborty P.Cardiac pacemakers: Indications, choices and follow up.
Oo ZT, Bhavsar D, Aung TPP, Ayala-Rodriguez CE, Kyaw H.Exercise stress test-induced atrioventricular dissociation with syncope.Ochsner J. 2021;21(3):319-324. doi:10.31486/toj.20.0134
Alturki A, Proietti R, Birnie DH, Essebag V.Management of antithrombotic therapy during cardiac implantable device surgery.J Arrhythm. 2016;32(3):163-9. doi:10.1016/j.joa.2015.12.003
Sohn HM, Ryu JH.Monitored anesthesia care in and outside the operating room.Korean J Anesthesiol. 2016;69(4):319-26. doi:10.4097/kjae.2016.69.4.319
Biocic M, Vidosevic D, Boric M, et al.Anesthesia and perioperative pain management during cardiac electronic device implantation.J Pain Res. 2017;10:927-32. doi:10.2147/JPR.S132241
University of Michigan Medicine.Arrhythmias and sexual activity.
American Heart Association.Living with your pacemaker.
American Heart Association.Pacemaker identification - wallet card.
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