Private practice is quickly going extinct in the US. It's generally not an option for US residency and fellowship graduates these days unless they are in one of

Private practice is quickly going extinct in the US. It's generally not an option for US residency and fellowship graduates these days unless they are in one of the specialties that has cash payors (plastics, dermatology, orthopedics, a small number of "concierge" primary care docs and psychiatrists that cater to rich patients, and a small number of ophthalmology practices that carved out a good Lasik business). The vast majority of pacemakers are placed by cardiologists with an additional two years of training in electrophysiology (not by cardiothoracic surgeons, who prefer to do complicated open heart surgeries and generally find things like pacemakers boring). Contrary to the conspiratorial thinking all over this thread, medical society guidelines have scaled back the indications for putting in pacemakers time and time again, so the market has shrunk. Electrophysiologists have to make up for the lost pacemaker volume by doing newer procedures (ablations) that reimburse less per hour of work. Even then, the volume at a lot of shops isn't enough to merit full time work. A lot of graduating electrophysiologists have to take mixed electrophysiology/general cardiology jobs where less than 50% of the work is electrophysiology. All that is to say, no, pacemakers are not a money making scheme. While there is decent money to be made, it's a shrinking market and those who got obscenely rich putting in pacemakers in the 80s and 90s have mostly already retired.