Introduction: Pacemaker implantation is an important method for the treatment of arrhythmias, but currently we may encounter the problem of infection of the implanted device in clinical practice, how should we prevent and reduce the infection? Infection is a serious complication after pacemaker implantation. According to the literature, the incidence is 1%-7% in foreign countries and about 2% in China, causing additional pain to patients, affecting their treatment and even endangering their lives, and must be taken seriously. We can start from the following three aspects: ① Prepare for a rainy day, prevent the problem before it happens. First of all, it is necessary to understand which groups of people are prone to infection, so that targeted preventive medication can be used. In general, patients with low resistance, cardiac insufficiency, renal insufficiency, and diabetes are prone to infections. In particular, it is important to emphasize that patients who have their pacemaker replaced again have an implantation infection rate that is more than three times higher at this time than at the first time. ②Know your enemy and you will never lose. The pathogenic bacteria causing pacemaker infections are mostly staphylococci, which are often transmitted through the patient’s skin, as well as through the hospital surroundings and the hands of health care workers, so we must pay attention to skin disinfection and hand hygiene. In addition, the electrodes for preoperative monitoring must not be attached to the site of pacemaker implantation, and if a temporary pacemaker is placed, it is better to implant it on the opposite side rather than on the same side. ③The surgeon should be careful and meticulous during the procedure. Carefulness means that the surgeon should strive for perfection in each case, and strive for the shortest possible operation time to reduce the time that the pacemaker and electrodes are surrounded by air. Carefulness means that attention to detail must be paid during the surgery, and details determine success or failure. First of all, it is important to know which company and which brand of pacemaker is installed, as the shape and size of the appearance of different company brands are not quite the same. Be sure to set the capsular bag according to the different models of pacemakers, not too loose or too tight, but the right size. Second, surgical hemostasis must be exact. Blood is the richest bacterial culture medium, and once there is blood, it is very easy for infection to occur. I prefer to use an electric knife to stop the bleeding because it is very thorough. There are three problems to avoid when placing the capsular bag, namely avoiding too tight, outward and too shallow. The greatest danger to the patient after pacemaker infection is endocarditis, which is the most serious. Pacemaker infection is divided into 5 phases in the guidelines, the first phase being incisional infection and the second phase being capsular bag infection, both of which can be treated if detected early with local or intravenous medication. Once the pouch breaks down in the third stage, it usually requires debridement. The fourth stage is the appearance of flap redundancy, where bacteria form on the wire or flap and require surgery to remove and extract the electrode. Stage V is the most serious, and may have no superficial signs of infection, but has generalized fever and positive blood cultures, and the electrodes must be removed. Pacemaker infections are 80% within one month, so patients must be followed up, and the patient must come back for the first month to see, first, how the pacemaker is functioning, and second, how the wound is doing. The patient is mostly discharged 4 to 5 days after the fitting. Before discharge, the doctor will instruct him to keep an eye on various conditions. If there is redness, swelling and pain, or a feeling of heat or fluctuation when touched, this may be a pacemaker infection. Once the skin breaks down, conservative treatment will not work, and the wound will definitely have to be debrided and re-implanted on the opposite side. Conclusion: As the scope of pacemaker implantation adaptation continues to expand, the occurrence of pacemaker and ICD postoperative infections is increasing, which requires us to pay sufficient attention. Strictly enforce aseptic operation, avoid risk factors as much as possible, and do a good job of postoperative prevention. Infection should be treated as early as possible once it occurs. In practice, we should choose the appropriate method to deal with it timely according to the specific situation to avoid more serious consequences.