Pacemakers are indicated in patients who have dangerously low heart rates, or who can't increase their heart rate with exercise. A HR of 30 is concerning and will cause symptoms with
normalNormal saline flush activity. A HR of 30 during sleep, however, is
normalNormal saline flush. There are also certain rhythms that warrant
pacemaker implantation, such as sick sinus or heart block. Pacemakers are very reliable. I would not be concerned about the reliability of any pacers put out by any of the 4 major companies out there.