Everyone's need is unique, and pros and cons must be thoroughly discussed to determine the best choice for yourself. I don't have a PM; however, I have an ICD (which I'm told can be used as a PM if needed)primarily for security and peace of mind. I had V-tach while I was in the hospital. Although my heart was able to come out of it on it's own, having poor ejection fraction, strokes, and clots, the health care professionals said it would be a good thing to have just in case. I too was concerned about all those things you mention. I don't recall being awake for the procedure, but if I was it was one of those conscious sedation things where you don't remember anything. My surgery went fine, and yes there is risks during that time, but any surgery has risk. My recovery went fine and I'm able to do all I did previously, except have an MRI. if I wear a shirt with a chest pocket, I've been able to put keep my phone in my pocket and not have any problems, nor have any problems been detected in any of my follow-up visits or digital downloads. I've had mine now for 4 years. Luckily as an ICD, my battery is going to last much longer than usual as I've not had any events causing it to fire. My 'bump' has always been body temperature, and after it fully healed, has never caused any pain or discomfort. knowing now that it hasn't needed to fire does seem like it was over-preventive; however, having that peace of mind really speaks HUGE volumes. Going through airport security isn't a huge issue, I carry my card with me, and generally involves a hand wanding if the walk through machine beeps. Again, minor inconvienience knowing I'm protected just in case. To me if a PM is being recommended or suggested, then their is enough going on to warrant having one. I had anxiety about getting one, and even after having it implanted. But at this point, I'm happy to have it, and would even do it again knowing what I know now that it wouldn't be needed for 4 years at least. Who knows what will happen in the next four years? All I know is it's there if I do have an event. I wish you the best!