**Abstract**

Since the introduction of pacemakers and defibrillators in the 1960s, many lives have been saved. The technologies used in the development and implantation of such devices are constantly improving, making the procedures increasingly effective and safe. However, the complexity of such implantations makes it one of the most important procedures that need high levels of expertise, knowledge, and experience on the part of the entire surgery team. There is a wide range of devices used for different purposes with various features and characteristics to suit different patients. They range from single-chamber and dual-chamber pacemakers to pulse generators and biventricular pacemakers. The present review chapter seeks to elaborate on the steps of pacemakers and defibrillators implantation, starting from patient selection to post-surgery care and patient education. It outlines all necessary measures in the preoperative, intraoperative, and postoperative stages to ensure the utmost safety, prevent infection, and avoid and treat further complications. The procedures used by our team have demonstrated satisfactory results for patients with a wide variety of conditions.

**Keywords:** pacemaker, defibrillator, PPM implantation, ICD implantation, anesthesia care
