Definition
A permanent cardiac pacemaker is a small, battery-powered medical device surgically implanted under the skin near the collarbone, with thin wires (leads) running into the heart. It monitors the heart's electrical activity and delivers small electrical pulses to keep the heartbeat steady when the heart's natural rhythm is too slow, irregular, or unreliable. The FAA may issue a medical certificate to a pilot with an implanted pacemaker, but only after a special review process that confirms the underlying heart condition is stable and the device is functioning properly.
Plain English
A small device put inside your chest to keep your heart beating at a steady pace when it can't do so reliably on its own. It stays in permanently and runs on a long-life battery. The FAA can still allow you to fly with one, but only after extra medical review.
Context Anchor
Seen in FAA medical certification material, medical history questions, and discussions with an Aviation Medical Examiner about heart conditions or implanted medical devices.
Derivation
‘Pacemaker’ literally means ‘something that sets the pace’ — here, the pace of the heartbeat. ‘Cardiac’ comes from the Greek kardia, meaning heart. ‘Permanent’ distinguishes the implanted, long-term device from temporary external pacemakers used short-term in hospitals.
Why Pilots Care
Presence of a permanent cardiac pacemaker requires FAA special issuance medical certification and ongoing follow-up evaluations to determine continued eligibility to fly.
Intuition Check
Do not read “permanent” as “never needs attention.” Here it means the device is implanted for ongoing use, even though it may still need medical checks or replacement parts over time.
Example Sentence 1
After his permanent cardiac pacemaker was implanted, the pilot worked with his AME and a cardiologist to apply for a Special Issuance medical certificate.
Example Sentence 2
Applicants with a permanent cardiac pacemaker must provide recent device interrogation reports before the medical exam can proceed.