Comparison

Periop Pacemaker vs ECGRef

Price, ratings, monetisation and update history for both apps, side by side — with what reviewers say about each.

Head to head
About

Periop Pacemaker

This app provides medical professionals with a decision algorithm for managing surgical patients with implantable defibrillators or pacemakers. It is based on guidelines endorsed by the Heart Rhythm Society and updated annually by an expert committee.

Highlights
  • Decision algorithm for pacemaker/defibrillator management
  • Endorsed by Heart Rhythm Society
  • Based on ASA Perioperative Cardiac Implantable Electronic Device Management Aid
  • Annual expert committee updates
  • Designed for medical professionals
Features
Read full description

Periop Pacemaker is a smartphone app that assists medical professionals who take care of surgical patients that have implantable defibrillators or pacemakers. The decision algorithm is endorsed by the Heart Rhythm Society and is based on the American Society of Anesthesiologists Perioperative Cardiac Implantable Electronic Device Management Aid. As device technology evolves, an expert committee of anesthesiologists, cardiologists, and device representatives will meet annually to keep information up-to-date. Disclaimer: ASA Pacemaker is designed for use by medical professionals only. Accessing the app content requires either a one-time payment of $7.99 USD or an annual subscription payment of $2.99 USD. A 30-day free trial is available under the annual subscription plan.

About

ECGRef

An educational reference for interpreting electrocardiograms, this app covers electrophysiology, rhythm recognition, and common patterns. It aims to assist clinicians and students in accurate bedside ECG analysis.

Highlights
  • Electrophysiology concepts
  • Rhythm recognition
  • Clinically relevant patterns
  • Bedside ECG analysis support
  • Educational reference
Features
Read full description

ECG interpretation, organized for the bedside. ECGRef is a comprehensive electrocardiogram reference for physicians, nurses, advanced practice clinicians, medical students, and other healthcare learners. Use a structured interpretation workflow, review rhythm patterns, explore ECG leads, check diagnostic criteria, and perform commonly used ECG calculations all in one focused reference. FEATURES • Step-by-step ECG interpretation workflow • Rhythm recognition and clinically relevant pattern review • Interactive frontal-plane and precordial lead explorer • Searchable library of ECG terminology and concepts • ECG calculators for heart rate, QTc, cardiac axis, ventricular hypertrophy, bundle branch block, wide-complex tachycardia, and more • Clinical risk tools • Bedside takeaways, common pitfalls, and “do not miss” findings • Favorites, global search, related content, and personal notes ECGRef connects core electrophysiology with practical ECG analysis. Whether you are learning a systematic approach, reviewing an unfamiliar rhythm, or checking a calculation, the app makes relevant information easy to find. Created by Rishi Kumar, MD, FACC (“RK.MD”), an academic adult cardiothoracic anesthesiologist and cardiovascular ICU intensivist committed to free, open-access medical education. Learn more at https://rk.md ECGRef is intended for educational and informational purposes only. It does not provide medical advice and is not a substitute for professional judgment, diagnosis, or treatment. Clinical findings and calculations must be independently verified and interpreted in the context of the individual patient. Seek guidance from a qualified healthcare professional regarding any medical condition. Do not disregard or delay professional medical advice because of information provided by this app.

Screenshots

Periop Pacemaker4 screens
ECGRef4 screens

Verdict

The call

The clearest difference is in-app purchases: ECGRef at none against Periop Pacemaker's 2. ECGRef also leads on update cadence (every 3 weeks vs every 2 months) and ratings volume (32 vs 9). Periop Pacemaker's advantage is iOS requirement (13.0 vs 26.0). On price, rating, review sentiment and ads there is nothing between them.

Scored on Price · Rating · Positive reviews · Number of ratings · Update frequency · Ads · In-app purchases · Monetization · Best chart rank · Devices · Requires iOS

CostPrice · In-app purchases · Ads · Monetization

Both are free to download. Periop Pacemaker sells 2 in-app purchases, starting at $2.99 per year. ECGRef asks for nothing beyond the download.

ReceptionRating · Positive reviews · Number of ratings

On the App Store both sit at effectively the same score — 4.9 for Periop Pacemaker against 4.9 for ECGRef. Both are backed by a comparable volume of ratings — 9 and 32 respectively. Written reviews split almost evenly too, at 100% and 100% positive.

UpkeepUpdate frequency

Periop Pacemaker ships an update every 2 months, ECGRef every 3 weeks. The most recent releases landed on November 4, 2026 and November 5, 2026 respectively.

Scorecard5 real differences · 5 level
Periop Pacemaker versus ECGRef: the parameters behind the verdict, then further details
ParameterPeriop PacemakerECGRef
PriceFreeFree
Rating4.9 (9 ratings)4.9 (32 ratings) — better
Positive reviews100.0% of reviews100.0% of reviews
Number of ratings932 — better
Update frequencyEvery 2 monthsEvery 3 weeks — better
AdsNoNo
In-app purchasesYesNo — better
MonetizationFree with in-app purchasesFree — better
DevicesiPhone, iPodiPhone, iPad
Requires iOS13.0 — better26.0
Further details — not scored
Size43 MB13 MB
Age rating17+17+
DeveloperRhythm Management, LLCRishi Kumar

Customer experience

Periop Pacemaker

All ratings8 ratings
Positive100.0%
Neutral0.0%
Negative0.0%
Written reviews5 reviews
Positive100.0%
Neutral0.0%
Negative0.0%

ECGRef

All ratings31 ratings
Positive96.8%
Neutral3.2%
Negative0.0%
Written reviews2 reviews
Positive100.0%
Neutral0.0%
Negative0.0%

In-app purchases

2 purchases

Periop Pacemaker

Subscriptions1
  • PERIOP PACEMAKER ANNUAL FEE1 Month trial$2.991 Year
One-time1
  • Periop Pacemaker$7.99
None

ECGRef

No in-app purchases

Questions

Is Periop Pacemaker free?
Periop Pacemaker is free to download, with in-app purchases available.
Is ECGRef free?
ECGRef is free to download, with no in-app purchases.
Which has better reviews, Periop Pacemaker or ECGRef?
ECGRef is rated higher. Periop Pacemaker averages 4.9 out of 5 from 9 ratings, while ECGRef averages 4.9 from 32 ratings.
Do Periop Pacemaker or ECGRef have ads?
Neither Periop Pacemaker nor ECGRef shows ads.
Which is updated more often, Periop Pacemaker or ECGRef?
Periop Pacemaker ships an update every 2 months, and ECGRef every 3 weeks. Most recently, Periop Pacemaker was updated on November 4, 2026 and ECGRef on November 5, 2026.

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