Recommendations on the structuring of cardiac pacemaker and defibrillator treatment-Update 2022

This interdisciplinary position paper of the German Cardiac Society (DGK) and the German Society for Thoracic and Cardiovascular Surgery (DGTHG) formulates evidence-based recommendations for the structuring and performance of device interventions. These are intended to create a Germany-wide basis for the infrastructural and personnel conditions of these operations. The necessary requirements for training centers and instructors are addressed, which should lead to a comparable quality in obtaining the additional qualification. The equally necessary infrastructural requirements of the institutions for the performance of the operations are defined. Thus, information is provided on personnel, spatial and hygiene requirements of the operating rooms as well as recommendations on radiological equipment and radiation protection. Also presented are procedural recommendations on clinical procedures, such as patient sedation and anesthesia, structuring emergency management, revision and extraction procedures, performing outpatient procedures, and implanting transcatheter leadless pacemakers. Last but not least, recommendations for the management of MRI examinations in device patients, remote follow-up of pacemaker and defibrillator patients, handling of safety notices and recalls, and German quality assurance of device interventions are described.