# Periop Pacemaker vs AnesthesiaRef

The clearest difference is in-app purchases: AnesthesiaRef at none against Periop Pacemaker's 2. AnesthesiaRef also leads on update cadence (every 3 weeks vs every 2 months) and ratings volume (28 vs 8). Periop Pacemaker's advantage is iOS requirement (13.0 vs 26.0). On price, rating, review sentiment and ads there is nothing between them.

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

On the App Store both sit at effectively the same score — 5.0 for Periop Pacemaker against 5.0 for AnesthesiaRef. Both are backed by a comparable volume of ratings — 8 and 28 respectively. Written reviews split almost evenly too, at 100% and 100% positive.

Periop Pacemaker ships an update every 2 months, AnesthesiaRef every 3 weeks. The most recent releases landed on September 27, 2026 and October 10, 2026 respectively.

## The numbers

| Metric | Periop Pacemaker | AnesthesiaRef |
| --- | --- | --- |
| Price | Free | Free |
| Rating | [5.0 (8 ratings)](https://appshunter.io/ios/app/periop-pacemaker/id6615070538/reviews) | [5.0 (28 ratings)](https://appshunter.io/ios/app/anesthesiaref/id6773007074/reviews) |
| Number of ratings | 8 | **28** |
| Positive reviews | 100.0% of reviews | 100.0% of reviews |
| In-app purchases | Yes | **No** |
| Ads | No | No |
| Update frequency | Every 2 months | **Every 3 weeks** |
| Monetization | Free with in-app purchases | **Free** |
| Size | 43 MB | 18 MB |
| Requires iOS | **13.0** | 26.0 |
| Devices | iPhone, iPod | iPhone, iPad |
| Age rating | 17+ | 17+ |
| Developer | [Rhythm Management, LLC](https://appshunter.io/developer/1761518402) | [Rishi Kumar](https://appshunter.io/developer/1434016052) |

## What reviewers say

### Periop Pacemaker

[App page](https://appshunter.io/ios/app/periop-pacemaker/id6615070538)

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:** macOS Compatibility, Vision Pro support

**In-app purchases (2)**

| Purchase | Price | Billing |
| --- | --- | --- |
| PERIOP PACEMAKER ANNUAL FEE | $2.99 | per year |
| Periop Pacemaker | $7.99 | one-time |


### AnesthesiaRef

[App page](https://appshunter.io/ios/app/anesthesiaref/id6773007074)

A comprehensive educational reference for anesthesiology professionals and students. It covers critical areas like airway management, crisis response, and perioperative decision support to promote safe anesthesia practices.

**Highlights:** Airway management, Crisis response protocols, Physiology and pharmacology, Procedure guides, Condition information, Calculators and checklists, Perioperative decision support

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none


## Frequently asked questions

### Is Periop Pacemaker free?

Periop Pacemaker is free to download, with in-app purchases available.

### Is AnesthesiaRef free?

AnesthesiaRef is free to download, with no in-app purchases.

### Which has better reviews, Periop Pacemaker or AnesthesiaRef?

Periop Pacemaker and AnesthesiaRef are both rated 5.0 out of 5 on the App Store, from 8 and 28 ratings respectively.

### Do Periop Pacemaker or AnesthesiaRef have ads?

Neither Periop Pacemaker nor AnesthesiaRef shows ads.

### Which is updated more often, Periop Pacemaker or AnesthesiaRef?

Periop Pacemaker ships an update every 2 months, and AnesthesiaRef every 3 weeks. Most recently, Periop Pacemaker was updated on September 27, 2026 and AnesthesiaRef on October 10, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*