CSI/IHRS practice guidelines on follow-up of patients with permanent pacemakers: a Cardiology Society of India/Indian Heart Rhythm Society task force report on practice guidelines on follow-up of patients with permanent pacemakers.

Implantation of a permanent cardiac pacemaker is a frequently used therapeutic modality. It has been estimated that approximately 25,000 pacemakers were implanted in India in 2011. Over the last five decades, cardiac pacemakers have evolved from single chamber non-programmable devices to dual chamber devices with extensive programmability. The implantation of the device is only the initial step in the lifelong management of the patient with a pacemaker, and long-term follow-up is vital not only for the safety of the patient but is also the key to optimal utilization of the pacing system. However in most places in our country, patients with implanted pacemakers are usually seen only annually and often only toward the end of pacemaker battery life. Due to the increasing number of pacemaker implants across India, the number of patients being admitted with the general physicians, having a pacemaker implanted or needing one has increased significantly. As many of these patients may be admitted with other medical problems, medical specialists are also now increasingly involved in their management. Although implantation and management of pacemakers fall primarily under the realm of the cardiologist, it is imperative that the general physicians also be conversant with some of the issues which impact the overall management of the patient. This document will deal with a broad overview of the elements of a follow-up program but will not attempt to describe various pacemaker-timing cycles, analysis of pacemaker ECGs or the procedure of identification or management of specific pacemaker-related troubleshooting.