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Introduction Dr Selwyn Brendon Goldthorpe Indications for the use of pacemakers and implantable cardioverter-defibrillators (ICDs) have become more defined over time, resulting in many more patients receiving these devices.1 Cardiac implantable electronic device (CIED) procedure is the term used to encompass pacemaker and ICD implant surgery. As of 2016, it was estimated that there were about 1.14 million pacemakers globally. By the year 2023, that number is expected to increase to 1.43 million units.2 Many nations are now keeping records of the implant complication rate for pacemakers and ICDs.3-6 As in any surgical procedure, a complication