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An organized system of follow-up is important for all device patients and is best facilitated through the patient s membership in a formal pacemaker/ICD follow-up clinic. The first formal clinic follow-up visit is usually scheduled at approximately 3 months after implantation to allow for completion of the lead-tissue maturation process, which may affect sensing and capture thresholds. Reprogramming, to account for any threshold change since implant, and still provide a safety margin along with improved battery life, may be done at that time. Optimization of device function can be performed noninvasively. The patient generally will have additional questions at this time, | Stores more commonly now have electronic surveillance devices to detect shoplifters and the technology involved varies. As is often the case, a detailed recommendation would depend on the exact device and the specific pacemaker. A general rule, however, is that if the patient with either an implantable defibrillator or pacemaker simply walks through the electric device without lingering and especially without staying within the electric field and turning around, the interference is likely to be minimal and of no clinical consequence. One problem is that these devices may not be apparent to the general public. The patient needs to be encouraged to lead a fairly normal life. We have heard anecdotally of one patient who would not enter any stores except through the back door and otherwise would leave the shopping to his wife. Such avoidance is being unduly concerned. At the same time, reasonable precaution should be taken to avoid the relatively rare situation of electromagnetic interference causing a problem when a patient lingers within the field of the electronic surveillance device. For example, when a friend
