**1. Introduction**

Cardiac pacemakers (PPM) and implantable cardioverter defibrillators (ICD) are electrophysiological devices that affect different aspects of patients' lives. Research and implantation of PPM and ICD began in the early 1960s. Nowadays, their role in the medical world is widely accepted because of advancements in new technologies and their widespread use, in addition to the improved life expectancy and quality of life in cardiac patients. Few companies produce and supply PPMs and ICDs.

They are a common treatment for irreversible bradycardia and tachyarrhythmias with specific indications. Cardiac pacemakers are made of a pulse generator that produces the electrical current required for the stimulation of the myocardium. One or two electrodes (leads) transmit the electrical activity from the pulse generator to the atrium and ventricle muscle.

As with other surgical procedures, patients require a precise evaluation and special care in preoperative, intraoperative, and postoperative periods. Implantation must be performed under anesthesia care. Anesthesia management plays a vital role as it involves general and local anesthesia.

Undoubtedly, despite the numerous benefits of using PPMs and ICDs, various local and cardiovascular complications may occur. Local complications include pain, swelling, wound hematoma, wound infection, and ipsilateral hemopneumothorax. Cardiovascular complications include lead displacement, lack of sensation and pacing, atrial and ventricular perforation, myocardial hematoma, diaphragmatic pacing, and cardiac tamponade.

Postoperative care should be short-term and long-term, which include wound care, patient education, taking medications, and periodic follow-up. The improvements in the patients' quality of life are very impressive after implantation and could be affected by programming compatibility and psychological, social, and economic behaviors.
