American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on Indications for the Use of Permanently Implanted Cardiac Pacemakers

In July 1991 a joint task force of the American College of Cardiology and the American Heart Association published a report that set forth guidelines for the implantation of cardiac pacemakers and antiarrhythmia devices.1 The report was comprehensive in scope and described the multiple abnormalities of intracardiac conduction in both adults and children for whom pacemaker implantation is appropriate. The report also described tachyarrhythmias that might be treated effectively with pacing. In addition, a section of the report discussed the use of implantable cardioverter-defibrillator devices. Finally, the report contained a section describing the various types of pacing devices that are currently available and the conditions for which they are useful.

The report did not specify that pacemakers or cardioverter-defibrillators should, or should not, be implanted by a specific type of physician. It was strongly recommended, however, that pacing "be performed by individuals with appropriate training who maintain their skills by participating in an adequate number of operations."

Although the technical information in this report will require periodic updating, the Advisory Council for Cardiothoracic Surgery of the American College of Surgeons finds it to be informative and the recommendations to be appropriate. The American College of Surgeons recognizes that many cardiothoracic surgeons are actively involved in this important and continually evolving area of practice.2 The College believes that the implantation of pacemakers and cardioverter-defibrillators is an appropriate part of residency training for cardiothoracic surgery.

Further, the College encourages practicing surgeons to remain current in their knowledge and application of available technology.


  1. ACC/AHA Task Force Report: Guidelines for implantation of cardiac pacemakers and antiarrhythmia devices. JACC, 191;18:1-13.
  2. Ferguson TB Jr, Linsday BD, Boineau JP: Should surgeons still be implanting pacemakers? Ann Thor Surg, 57:588-97, 1994.

Reprinted from Bulletin of the American College of Surgeons
Vol. 81, No. 2, Page 40, February 1996