A cardiac pacemaker is an electronic device that delivers direct electrical stimulation to stimulate the myocardium to depolarize, initiating a mechanical contraction. The pacemaker initiates and maintains the heart rate when the heart’s natural pacemaker is unable to do so. Pacemakers can be used to correct bradycardias, tachycardias, sick sinus syndrome, and second- and third-degree heart blocks, and for prophylaxis. Pacing may be accomplished through a permanent implantable system, a temporary system with an external pulse generator and percutaneously threaded leads, or a transcutaneous external system with electrode pads placed over the chest.

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