Pacemaker implantation involves preparing the patient with consent forms, antibiotics, and stopping blood thinners. The procedure sterilizes the patient and tools, creates venous access and a pocket under the skin, and places leads in the right ventricle and atrium. Measurements are taken to ensure proper pacing and the wound is closed with antibiotics and specific post-op instructions. Complications can potentially occur.

1. PACEMAKER IMPLANTATION
Waleed Roshdy , TRG

2. PRE-OPERATIVE CHECKLIST
 Written Consent
 Antibiotics
 Analgesic and sedative agents
 Surgical tools and operating room
 Stoppage af antiplatelets and anti-coagulants
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 Pre-operative laborartory tests

3. STEPS OF IMPLANTATION
1- STERILIZATION (patient and surgical tools )

4.  CENTRAL VENOUS ACCESS TECHNIQUES

5. TARGET VEINS FOR ACCESS

6. 3- INCISION AND POCKET FORMATION

7. RV LEAD PLACEMENT
 Position and stability
Techniques :
# prolapsing
# drop down
# direct crossing

11. MESUREMENT (PACING THRESHOLD AND R
WAVE MESUREMENT)

13. ATRIAL LEAD PLACEMENT

14. FINAL STEPS
#closing the wound
#Antibiotics
#Covering the wound
#Specific instructions

15. COMPLICATIONS