**1. Introduction**

Postoperative pain of all types is often under-treated and may lead to chronic postsurgical pain, a centralized painful condition that can be challenging to treat [1]. Reports of postimplant pain can vary. In a survey of pacemaker patients, most patients were satisfied overall with their device and not affected by pain, soreness, or discomfort [2]. Yet in another study, over 40% of surgical patients from a singlecenter Italian study (*n* = 235) reported still having mild postsurgical pain at six months [3]. Despite the frequency of device implants for cardiac conditions, there is little study on the incidence, intensity, or duration of pain associated with cardiac implantable electronic device (CIED) implantation.

There is a paucity of literature to inform clinicians about pain management for those undergoing an implantable cardioverter-defibrillator (ICD) or pacemaker implantation. A single-center study from Europe (*n* = 372) analyzed pain control retrospectively over the course of device implant [4]. The study found about a quarter of patients received analgesia or sedation in advance of surgery. During surgery, all patients received local lidocaine anesthesia. Upon completion of the surgery, less than one-third (31%) were given pain medication or sedated. Using a 0 to 10 numeric rating scale, the highest pain rating during the implantation was 8. Pain above 5 was reported one, three, six, eight, and 24 hours after surgery, with the most frequently reported pain sites being the surgical incision, shoulder area, and chest region [4].
