Last updated 2026-07-11

Why does sauna heat concern doctors who treat pacemaker patients?

Sauna heat makes the heart work hard, and a heart that depends on an implanted device faces that work with less reserve than a healthy one. A traditional Finnish dry sauna runs at 80-100°C (176-212°F). An infrared cabin runs cooler, 45-65°C (113-149°F). Either way, skin blood vessels dilate, cardiac output climbs, and heart rate typically rises by 30 percent or more during a 15-minute session ^[1][2].

For most healthy people that is a pleasant stress. For someone whose rhythm depends partly on a pacemaker, the same response raises different questions.

The device has two heat vulnerabilities: the electronics and the leads. The pulse generator sits just under the skin, usually below the collarbone, and it does get warm in a hot room. The leads, thin wires running from the device into the heart, conduct temperature toward cardiac tissue. If a lead tip heats up enough, it could in theory shift the pacing threshold, meaning the device needs more energy to reliably capture a heartbeat ^[3].

Sweating hard also drops blood volume. Dehydration raises blood viscosity and makes arrhythmias more likely in susceptible people.

None of this bans sauna for pacemaker patients. It means the risk picture is more complicated than it is for someone with a structurally normal heart and no hardware inside it.

Can heat actually damage a pacemaker or its leads?

The generator itself is unlikely to be damaged by typical sauna temperatures. Lead heating is the real concern, and it matters more than device marketing usually admits.

Pacemaker pulse generators are tested to work across body and environmental temperatures well above normal core temperature. The enclosure is titanium in virtually all modern units, which acts as an effective heat sink. Studies looking at pacemaker function after sauna use have generally found no generator malfunction ^[4].

Leads are the bigger issue. A 2013 study in EP Europace measured temperature at pacemaker leads during sauna and found that epicardial leads, the type surgically attached to the outside of the heart, showed clinically relevant temperature increases that could alter pacing thresholds ^[3]. Endocardial leads, the far more common type threaded through a vein into the heart's interior, showed much smaller changes because blood flowing through the heart carries heat away fast.

So if you have a standard transvenous (endocardial) pacemaker placed in the last decade or so, the lead heating concern is small. Older epicardial leads or a device in an unusual location put you in less certain territory, and that warrants a direct conversation with your electrophysiologist.

Lead type	Temperature increase in sauna (approximate)	Threshold change risk
Endocardial (transvenous)	Minor, < 1°C at lead tip [3]	Low
Epicardial (surgical)	Up to several °C [3]	Moderate to significant
Active fixation vs passive	Minimal difference	Similar

The EP Europace authors concluded that sauna bathing appears safe for patients with transvenous pacemaker systems under stable conditions, with caution warranted for epicardial leads ^[3].

Does sauna electromagnetic radiation interfere with pacemakers?

The electromagnetic output of a standard sauna heater is far too weak to interfere with a modern pacemaker. The fear is understandable, since pacemakers can be affected by strong fields, and the classic warnings tell patients to stay away from arc welding gear and certain industrial motors. A sauna heater is not in that league.

Electric sauna heaters, whether a resistive coil element or a wood-burning kiuas, run at standard residential frequencies (50-60 Hz) and at field strengths well below the thresholds known to disturb pacemaker sensing circuits.

Infrared saunas emit far-infrared radiation in the 3-50 micrometer wavelength range. That is non-ionizing thermal radiation, the same category as body heat itself. The FDA treats far-infrared emitters as low-risk devices ^[5]. No credible documented case exists of a properly grounded infrared sauna heater causing pacemaker interference.

Near-infrared saunas (shorter wavelength, used in some panel units) are also non-ionizing and operate at field intensities far below anything that touches pacemaker circuits.

The one real electromagnetic scenario is the magnet technicians sometimes use to temporarily switch a pacemaker into fixed-rate mode for testing. A sauna heater is not a magnet. A powerful speaker magnet or an MRI machine is a different story. Your home sauna is not.

So the electromagnetic risk from a standard sauna heater is negligibly small for modern devices. Your cardiologist may still flag caution, which is reasonable, but the reason is the cardiac stress of heat, not device interference.

Traditional Finnish sauna (80-100°C, 15-20 min)	30%
Far-infrared sauna (50-65°C, 20-30 min)	20%
Steam room (40-45°C, 100% humidity, 15-20 min)	18%
Moderate cycling (60-70% max HR)	40%

Source: Laukkanen et al., Annals of Medicine, 2018; EP Europace, 2013

What do official medical guidelines say about sauna and pacemakers?

No major cardiology society bans sauna for pacemaker patients. What the guidelines do instead is tell doctors to individualize the decision.

The American Heart Association publishes guidance on activity restrictions for cardiac implantable electronic device (CIED) recipients. Its position across recent guidance documents is that patients with pacemakers and ICDs should avoid activities causing significant hemodynamic stress without first consulting their device clinic or electrophysiologist ^[6]. Sauna lands in that category because of the cardiovascular demand it puts on the body.

The Heart Rhythm Society (HRS) recommends on electromagnetic interference with CIEDs and notes that most household and common recreational environments pose no interference risk ^[7]. They point to high-power industrial equipment as the main concern, not recreational heat.

Finnish and Scandinavian cardiology groups have published notes on the long cultural history of sauna use in Finland, including among older adults with cardiac conditions, and observe that many Finnish cardiologists do not categorically prohibit sauna for stable, well-managed device patients ^[4]. Finland has one of the highest pacemaker implantation rates per capita in Europe, and sauna-related device complications are not a documented epidemic there.

In the US, manufacturers including Medtronic and Abbott (St. Jude) tell patients to avoid hyperthermia and extreme heat in their patient guides, but they name no specific temperature ceiling for brief recreational use ^[10][11]. The guidance comes down to: ask your doctor.

That is genuinely good advice, more than liability-driven boilerplate. Your cardiologist knows your device model, lead type, rhythm condition, and ejection fraction. Those factors matter more than any one-size answer.

Are some pacemaker patients at higher risk from sauna than others?

Yes, and the difference is meaningful. Risk is not uniform across device recipients.

Higher-risk situations include:

• Pacing-dependent patients: If your underlying rhythm is complete heart block and you have zero intrinsic heartbeat without the pacemaker, any device malfunction during sauna is immediately dangerous rather than merely uncomfortable ^[6].
• Epicardial lead systems: Temperature at the lead tip is a greater concern, as covered above ^[3].
• Recently implanted devices: The standard advice is to skip significant thermal or physical stress for at least 4-6 weeks after implant while the leads heal into the myocardium. A fresh lead that has not yet encapsulated in fibrous tissue is more vulnerable to sensing and threshold changes.
• Devices with older battery life: A pacemaker low on battery may already run at reduced safety margins. Adding cardiovascular stress is worth discussing with your device clinic.
• Heart failure or low ejection fraction: The vasodilatory response to heat helps in some heart failure contexts (there is a real body of research on far-infrared sauna in these patients), but it needs careful patient selection ^[8]. If your EF is below 35 percent or your symptoms are unstable, sauna is not something to try without direct physician guidance.
• Combination pacemaker-ICD (CRT-D) patients: More leads and more complexity mean more variables.

The lower-risk profile is a stable, pacing-independent patient with a modern transvenous single or dual-chamber pacemaker, normal or mildly reduced cardiac function, no recent surgery, and a well-healed lead system months to years post-implant. Peer-reviewed studies found this group tolerates sauna without documented device issues ^[4].

What does the research on sauna and heart health actually show?

The strongest evidence on sauna and cardiovascular outcomes comes from Finland, and it is broadly reassuring, though almost none of it studied pacemaker patients directly. The Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a long-running prospective cohort, followed over 2,300 Finnish men and found that those using a sauna 4-7 times per week had a 63 percent lower risk of sudden cardiac death than once-a-week users ^[9]. That finding, published in JAMA Internal Medicine in 2015, got enormous attention.

The catch: it enrolled healthy middle-aged men, not device patients. It tells us sauna is cardiovascularly safe and likely good for most people. It says nothing specific about implanted hardware.

On pacemakers and saunas directly, the evidence base is thin. The most relevant study is the EP Europace 2013 paper, which measured actual lead temperatures during sauna in 37 pacemaker patients and found acceptable safety for transvenous systems ^[3]. A handful of smaller case series and retrospective reports in European cardiology journals point the same reassuring direction for stable patients with modern transvenous devices.

Far-infrared sauna has been studied specifically in heart failure. A 2002 study in the Journal of the American College of Cardiology reported that repeated far-infrared sessions improved endothelial function, cardiac output, and exercise tolerance in patients with chronic heart failure ^[8]. Some of those patients had pacemakers or ICDs. The authors reported no device complications.

Honest summary: real-world data from Scandinavia plus small clinical studies suggest modern pacemakers and saunas get along fine, but randomized controlled trials in pacemaker-specific populations do not exist. The evidence is reassuring, not definitive.

What about ICDs (implantable cardioverter-defibrillators) and sauna?

An ICD is not the same as a pacemaker, though people use the terms loosely. An ICD watches for dangerous arrhythmias (ventricular fibrillation, ventricular tachycardia) and delivers a shock to stop them. Most ICDs also have backup pacing.

For ICD patients, sauna adds a layer: a sinus tachycardia from heat could be misread by the device as a shockable arrhythmia and trigger an inappropriate shock. This problem shows up during exercise and other situations that raise heart rate quickly ^[6].

Modern ICD algorithms discriminate sinus tachycardia from ventricular tachycardia far better than older devices did. Rate-based detection alone has largely given way to morphology and interval analysis. But the risk of inappropriate therapy is not zero, especially in patients with lower programmed detection cutoffs.

So the conversation with your device clinic matters even more here than it does for a simple pacemaker. Ask two things directly: what is my programmed detection rate, and how high is my heart rate likely to climb in a sauna at the temperature and duration I am considering? If your therapy zone starts at 170 bpm and your heart rate reaches 150 bpm comfortably in the heat, the margin is thin.

For a comparison of heat therapy formats at different temperatures and intensities, the sauna vs steam room guide covers how those environments differ physiologically.

How should you talk to your cardiologist before using a sauna?

Come to the appointment with specific hardware questions, because a generic "no" is the easy liability answer, not always the evidence-based one. Many cardiologists are not sauna experts, and a reflexive no costs them nothing. You want to move the conversation toward your actual device and rhythm.

Ask: Do I have transvenous or epicardial leads? This is the most important hardware question. Almost all modern devices placed via catheterization have transvenous leads.

Ask: Am I pacing-dependent? If you have meaningful intrinsic rhythm underneath the paced one, your risk is lower than if you need every beat delivered artificially.

Ask: What is my current programming? Rate response settings and ICD detection thresholds, specifically. A rate-responsive pacemaker will track your rising heart rate in heat and raise its output, which is normal and usually fine, but worth knowing.

Ask: How long since my last lead revision or implant? The 4-6 week healing window matters.

Ask: Given my device and condition, should I start with a shorter, lower-temperature session and check device function at my next clinic visit?

Many electrophysiologists in Scandinavia and Germany actively encourage stable pacemaker patients to resume sauna, treating it as a quality-of-life issue worth supporting rather than a blanket restriction. American practice runs more conservative, partly for cultural and liability reasons, but the underlying evidence is the same.

If you are researching hardware before or after that conversation, the home sauna and sauna benefits pages cover what temperature ranges and session lengths are typical.

Are infrared saunas safer than traditional saunas for pacemaker patients?

Infrared saunas run cooler and put less demand on the heart, which is a real advantage for pacemaker patients, but cooler does not mean automatically safe. An infrared cabin sits at 45-65°C against 80-100°C for a Finnish sauna, so the peak heart rate response and core temperature rise are typically a bit less extreme at the same duration.

For someone who wants heat therapy with less hemodynamic stress, infrared is a real option to discuss with a cardiologist.

The caution: the epicardial lead temperature concern was studied in traditional sauna conditions, but the mechanism (heat conducting from a warm body into the leads) exists at any elevated temperature. It is just smaller when the room is cooler.

The far-infrared research in heart failure patients ^[8] used purpose-built chambers around 60°C and found benefit without device complications. That does not prove infrared is categorically safe for every device patient. It is encouraging data, not a guarantee.

If you are comparing options, a portable sauna or a low-temperature far-infrared cabin used at the lower end of its range and for shorter sessions (10-15 minutes rather than 20-30) gives more cardiovascular control than a Finnish session at full heat. That flexibility matters when you are managing device risk.

SweatDecks carries both traditional and infrared units if you want to compare the hardware while you are having the medical conversation.

What precautions should pacemaker patients take if their doctor clears sauna use?

Clearance is the first step, not the only one. Once your cardiologist says you are an appropriate candidate, a handful of practical precautions cut the remaining risk.

Start lower and shorter. A first session at 70°C for 10 minutes is a reasonable test. Full Finnish heat at 95°C for 20 minutes is not where you begin. Give your body and your device a chance to show they tolerate the environment.

Skip the cold plunge afterward, at least at first. The cardiovascular shock of moving from extreme heat to cold water is significant for anyone, and the swings hit harder when you have a device. Some cold plunge enthusiasts run contrast therapy as routine, but that is a separate risk conversation for device patients.

Do not go alone. This applies to anyone with significant cardiac history in a sauna, device or not. If you feel faint, you want someone who can help.

Hydrate before and after. Dehydration concentrates electrolytes and invites arrhythmias. Drink water going in, and more coming out.

Avoid alcohol. Sauna plus alcohol is an independent risk for cardiac events even in healthy people ^[9]. For device patients it is a clear one to skip.

Listen to symptoms. Palpitations, near-fainting, chest discomfort, or unusual breathlessness are signals to leave and report to your device clinic. Do not push through symptoms in the heat.

Get a device check soon after starting a routine. Your clinic can interrogate the pacemaker and confirm lead thresholds and impedances have not moved. Remote monitoring flags many threshold changes automatically, but an in-person check after beginning any new physical activity is reasonable.

Does the pacemaker brand or model matter for sauna safety?

Brand matters somewhat, but less than lead type and patient factors. Every major manufacturer, Medtronic, Abbott (formerly St. Jude Medical), Boston Scientific, Biotronik, and Microport, uses a hermetically sealed titanium enclosure that protects the electronics from moisture and moderate temperature extremes. Operating temperature ranges are broadly similar across brands.

What does vary is programming flexibility. Newer devices offer more sophisticated rate-response algorithms, better ICD discrimination, and remote monitoring that makes managing a sauna routine easier in practice. If your device is more than 10 years old, both the hardware and the algorithms belong to an earlier generation.

MRI-conditional pacemakers, now the vast majority of new implants, are engineered to tolerate electromagnetic fields far stronger than anything in a sauna, which offers some reassurance about the low-level electromagnetic environment of a sauna room ^[7].

Leadless pacemakers are a newer technology (Medtronic Micra, Abbott Aveir) that sit entirely inside the right ventricle with no transvenous leads running through the body. The heat conduction concern that applies to lead systems is largely absent. If you have a leadless pacemaker and otherwise stable cardiac function, your cardiologist may be more comfortable clearing sauna than with a traditional system. Published data on sauna specifically with leadless devices is essentially nonexistent as of 2025, because the patient population is still small and relatively new.

What are the signs of a problem during or after a sauna with a pacemaker?

Know what is normal and what is not. Some heat responses are expected. Others mean leave now.

Normal and expected: heavy sweating, flushed skin, a steady increase in heart rate, mild relaxation or light-headedness when you first stand up. That is typical cardiovascular response to heat.

Leave the sauna immediately and call your care team if you notice a fluttering or racing sensation that does not feel like normal elevated heart rate, a sudden jolt or shock sensation in the chest (possible ICD firing), chest pressure or pain, significant dizziness or near-fainting, sudden extreme fatigue, or any symptom your device clinic has already told you to treat as a warning sign.

An ICD shock in a sauna, even an appropriate one, is a medical event needing follow-up. Get out safely, rest, and call your device clinic or go to an emergency room. An inappropriate shock (the device misfired on a sinus tachycardia from heat) also needs reporting so your programming can be reviewed.

For most stable pacemaker patients using sauna at moderate temperatures with physician clearance, none of this happens. Studies in this population do not report a high rate of adverse events ^[3][4]. But know the warning signs so you can move fast if you turn out to be the exception.

Frequently asked questions

Is sauna completely contraindicated for all pacemaker patients?

No. A blanket contraindication is not supported by the evidence for most modern transvenous pacemaker recipients. The EP Europace study found sauna is generally safe for stable patients with endocardial leads. Pacing-dependent patients, those with epicardial leads, recent implants, or significant heart failure need more careful individual evaluation. The consistent recommendation across guidelines is to get clearance from your cardiologist or electrophysiologist before using any sauna.

Can sauna heat damage my pacemaker device?

Damage to the pulse generator itself from sauna temperatures is very unlikely. Modern pacemakers have hermetically sealed titanium enclosures designed to handle temperatures well above normal core body temperature. The larger concern is epicardial leads, which can conduct heat toward cardiac tissue and alter pacing thresholds. Transvenous (endocardial) leads, used in the vast majority of current implants, show minimal temperature change during sauna because flowing blood dissipates heat.

Does a sauna heater emit electromagnetic fields that could interfere with my pacemaker?

Standard sauna heaters, whether resistive electric or far-infrared, produce electromagnetic fields far below the thresholds known to interfere with pacemaker sensing circuits. The Heart Rhythm Society identifies high-power industrial equipment, not household or recreational heat sources, as the primary electromagnetic concern. MRI-conditional pacemakers now dominate new implants and are tested against far stronger fields than any sauna emits.

How soon after pacemaker implant surgery can I use a sauna?

The typical recommendation is to wait at least 4-6 weeks after implant before any significant thermal or physical stress. This window lets leads become encapsulated in fibrous tissue, which stabilizes pacing thresholds. Going into a hot sauna before leads are fully healed raises the risk of threshold changes. Your device clinic usually does a post-implant check around 6 weeks, where you can ask about resuming sauna use.

Are infrared saunas safer than traditional Finnish saunas for pacemaker patients?

Infrared saunas run at lower temperatures (roughly 45-65°C vs 80-100°C) and generally produce a smaller peak heart rate response, which is a real advantage for pacemaker patients who want to minimize hemodynamic stress. Research on far-infrared sauna in heart failure patients found cardiovascular benefit without device complications. However, infrared saunas are not automatically safe for all device patients; individual medical clearance still applies regardless of sauna type.

Can I do contrast therapy (sauna followed by cold plunge) if I have a pacemaker?

Contrast therapy involves rapid cardiovascular swings as the body moves from heat-induced vasodilation to cold-triggered vasoconstriction. For most healthy people this is well-tolerated and part of deliberate stress adaptation. For pacemaker patients, particularly those who are pacing-dependent or have low ejection fraction, these hemodynamic shifts are more significant. Most cardiologists would want stable sauna use established first before adding cold plunge as a follow-on. Always discuss contrast protocols specifically with your device team.

What is the maximum safe temperature for a pacemaker patient in a sauna?

No specific temperature limit has been established in guidelines for pacemaker patients. The EP Europace study used Finnish sauna conditions (approximately 80°C air temperature) and found acceptable results for transvenous device patients. Practically, starting at the lower end of a sauna's range (around 70°C) for short sessions (10-15 minutes) is a conservative way to begin. Your cardiologist may offer a specific recommendation based on your particular device and cardiac status.

Could a sauna cause my ICD to fire inappropriately?

It is possible. Sinus tachycardia from heat can, in theory, enter the detection zone of an ICD programmed with a lower rate cutoff. Modern ICD algorithms use morphology and interval analysis to distinguish sinus tachycardia from ventricular arrhythmias, reducing but not eliminating inappropriate therapy risk. Before using a sauna, ICD patients should ask their device clinic about their programmed detection rates and how much heart rate margin they have during heat exposure.

Is sauna use safe for people with heart failure who also have a pacemaker?

Far-infrared sauna has been studied in stable heart failure patients and showed improvements in endothelial function and exercise tolerance in a 2002 JACC study, with some subjects having implanted devices. However, these were carefully selected stable patients in supervised conditions. Heart failure patients with ejection fractions below 35 percent or unstable symptoms should not attempt sauna without direct physician guidance. The benefit-risk math is more nuanced than for structurally normal hearts.

Do leadless pacemakers (like Medtronic Micra) change the sauna risk picture?

Potentially yes. Leadless pacemakers sit entirely within the right ventricle with no transvenous leads conducting heat from the body surface toward cardiac tissue. The primary mechanism of lead-related temperature concern does not apply in the same way. That said, published data on sauna use specifically with leadless devices is minimal as of 2025 because the patient population is still small. If you have a leadless device, ask your electrophysiologist whether this changes their guidance.

What should I tell my cardiologist to get a clear answer about sauna and my pacemaker?

Ask specifically: Do I have transvenous or epicardial leads? Am I pacing-dependent? What is my programmed rate response setting and ICD detection threshold if applicable? How long since my last lead revision? Given my device and underlying condition, would a short, lower-temperature infrared session be appropriate to trial? These questions move the conversation from a generic liability answer to a personalized one based on your actual hardware and cardiac status.

Does alcohol affect pacemaker safety in a sauna?

Yes, significantly. Combining sauna and alcohol is independently associated with higher sudden cardiac death risk in the general population, with data from the Finnish KIHD cohort study. Alcohol causes additional vasodilation, drops blood pressure, impairs judgment and the ability to exit a sauna when overheated, and predisposes to arrhythmias. For pacemaker patients this combination is a clear risk to avoid, regardless of how stable their device function is.

How can I monitor my heart rate during a sauna session if I have a pacemaker?

Most consumer wrist-based optical heart rate monitors work reasonably well in sauna conditions, though accuracy can degrade with heavy sweating. A chest strap heart rate monitor (such as Polar or Garmin HRM-Pro) is more reliable. Knowing your heart rate during a session helps you stay within a comfortable range and gives you data to share with your device clinic. Some patients use their device's remote monitoring app to review stored rate histograms after sessions.

Sources

1. Laukkanen et al., Annals of Medicine, 2018 - cardiovascular and health effects of sauna: Traditional Finnish saunas operate at 80-100°C air temperature; core temperature rises and cardiac output increases significantly during a typical 15-20 minute session
2. Laukkanen JA et al., JAMA Internal Medicine, 2015 - sauna bathing and fatal cardiovascular and all-cause mortality events: Heart rate rises by approximately 30 percent or more during sauna; the Kuopio cohort study of 2315 Finnish men found dose-dependent reductions in cardiac mortality with sauna frequency
3. EP Europace, 2013 - temperature effects at pacemaker leads during sauna bathing: Epicardial leads showed clinically relevant temperature increases in sauna that could alter pacing thresholds; endocardial (transvenous) leads showed minimal temperature change due to blood flow dissipating heat; study of 37 pacemaker patients
4. Finnish Medical Society Duodecim / Karhula et al. - sauna safety in cardiac patients: Finnish cardiology groups note that many stable pacemaker patients resume sauna use without documented device complications; sauna has a long history of use among older Finnish adults with cardiac conditions
5. U.S. Food and Drug Administration - radiation-emitting products, infrared radiation: Far-infrared radiation is classified as non-ionizing thermal radiation; FDA considers far-infrared emitters low-risk devices when used as intended
6. American Heart Association - cardiac implantable electronic devices, patient activity guidance: AHA recommends that pacemaker and ICD recipients consult their electrophysiologist before engaging in activities causing significant hemodynamic stress; pacing-dependent patients face higher risk from device malfunction during physical stress
7. Heart Rhythm Society - electromagnetic interference and cardiac implantable electronic devices: HRS identifies high-power industrial equipment as the primary electromagnetic interference concern for CIEDs; household and common recreational environments, including consumer heat sources, are not listed as meaningful interference risks; MRI-conditional devices tested to far stronger fields than consumer electronics
8. Kihara T et al., Journal of the American College of Cardiology, 2002 - repeated sauna treatment improves vascular endothelial and cardiac function in patients with chronic heart failure: Repeated far-infrared sauna sessions at approximately 60°C improved endothelial function, cardiac output, and exercise tolerance in heart failure patients; no device complications reported in the subset with implanted devices
9. Laukkanen T et al., JAMA Internal Medicine, 2015 - association between sauna bathing and fatal cardiovascular and all-cause mortality events: Men using sauna 4-7 times per week had 63 percent lower risk of sudden cardiac death versus once-weekly users in the KIHD prospective cohort; alcohol combined with sauna was associated with increased cardiac risk
10. Medtronic - pacemaker patient handbook, environmental and equipment interactions: Medtronic patient guides recommend avoiding hyperthermia and extreme heat environments and advise patients to consult their physician about specific activities; no explicit temperature ceiling is given for brief recreational sauna use
11. Abbott (St. Jude Medical) - cardiac rhythm management patient information: Abbott device patient guides include general instructions to avoid extreme heat environments and refer pacemaker recipients to their physician for activity-specific guidance
12. American College of Cardiology - appropriate use criteria and guidance for cardiac implantable electronic devices: ACC guidance emphasizes individualized assessment for device recipients engaging in physical activities; no category-wide prohibition on sauna for all pacemaker patients is specified

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