How often should I go to the hospital for follow-up after pacemaker installation? Follow-up visits are generally required once every 1, 3 and 6 months after implantation, and every 3 to 6 months thereafter, depending on the type of pacemaker and changes in the condition, and should be shortened if the pacemaker is approaching the end of its useful life. What should the patient be aware of during the follow-up period? Patients need to know whether there are any changes before and after the pacemaker implantation, such as whether the existing symptoms of dizziness, blackness, syncope, etc. have disappeared or whether new symptoms have appeared; the doctor will conduct post-operative questioning and physical examination according to the specific situation. Routine physical examination includes blood pressure, pulse rate, respiratory rate, body temperature, etc. Other examinations include healing of the pacemaker bag and incision, observation of changes in local skin color and temperature, changes in skin tension, pressure pain, fluctuating sensation to exclude local bag hematoma or infection, and the presence of varicose veins in the anterior chest wall and swelling of the upper limbs on the painful side. Auxiliary examination methods: conventional 12-lead ECG can observe whether the heart is pacing and perceiving well, and generally determine the working condition of the pacemaker. 24h ambulatory ECG can observe the function of the pacemaker, whether intermittent or transient symptoms and arrhythmias are related to pacing, understand the degree of dependence on the pacemaker, the trend of changes in self or pacing frequency after activity, and analyze certain pacemaker-related arrhythmias. The patient should be followed up periodically with a chest X-ray. In addition, periodic chest x-rays should be performed during follow-up to compare with the previous chest radiograph or even the chest radiograph at the time of implantation to observe the position of the lead for displacement and integrity and the position of the pacemaker. Echocardiography is often used to assess the size of the heart, changes in cardiac structure, the status of cardiac function, valve regurgitation, and the relationship between different pacing modalities and cardiac hemodynamics before and after pacing therapy. Pacemaker programming refers to the use of a non-invasive method (programmable controller) to transmit preset parameters to the pacemaker through the programmable controller to change the pacemaker parameter settings for the purpose of adjusting the pacing mode and pacing parameter settings. Commonly used programmable parameters include pacing mode, frequency, output amplitude, perception, inappropriate period, AV interval, mode conversion, etc. Pacemaker pacing mode is selected according to the actual clinical needs and changed by program control. The pacing frequency refers to the number of electrical pulses per minute issued by the pacemaker. In addition to the basic pacing frequency, there are also hysteresis frequency, upper limit frequency and lower limit frequency. The output amplitude of the pacemaker refers to the voltage or current intensity of the pulse, and the output energy of the pacemaker is equal to the product of voltage, current and pulse width. Usually, the output voltage and pulse width can be programmed to change. Clinically, the voltage is mainly programmable, and the pulse width is programmable when necessary. 4. Programmable perceptual sensitivity: The perceptual function refers to the ability of the pacemaker to perceive a certain amplitude of R- or P-wave on demand. Sensing sensitivity refers to the pacemaker’s ability to suppress the release of its own pulse after sensing the lowest amplitude R-wave or P-wave, usually measured in millivolts (mV). 5. Programmed control of the nonresponse period: The nonresponse period is the time interval after the pacemaker has delivered an electrical pulse or sensed its own rhythm when the sensing amplifier is turned off and no further signal is sensed and no pulse is delivered. It also includes programming of the atrioventricular (A-V) interval, lead polarity, and mode switching functions. In conclusion, the important values of programmed control are individualization of pacing parameters, prolongation of pacemaker life, prevention or management of pacemaker malfunction and complications, and avoidance of surgical probing, thus improving the safety and reliability of pacemakers for the purpose of improving patient quality of life.