To the implantable cardiac devices belong now the pacemakers, implantable defibrillators and subcutaneous defibrillators. The aim of this tutorial is to show the possibilities of the recent programmable features within these devices and their using in practice. The trouble-shooting part of the tutorial provides the overview of most common issues to solve in the clinical practice, like supporting/elimination of own patient rhythm, individual need of pac-ing, environment and electromagnetic disturbance. The technical standardization require-ment will also be covered. For dual chamber pacemakers, the timing of ventricular pacing, realized by AV delay parameter, is fundamental. It can be either fix or dynamic, incorporated the specific algo-rithms for AV delay extension. As the ventricular filling phase influences the patient hemo-dynamics, and an abundance of ventricular paced beats should be avoided, this parameter is critical. For implantable defibrillators, the optimization of tachycardia detection process is of primary importance. False-positive shocks are quite often in the praxis. Therefore the trends of patient rhythm should be evaluated during ambulatory follow-ups and detection settings adjusted appropriately. Detection zones, sensing threshold, duration, morphological algo-rithms – all these parameters will be discussed in details. The similar situation is for subcu-taneous defibrillators, where however the settings have no so many options. All implantable cardiac devices settings should be individualized. This educational course helps to better understanding of advanced settings.