Aim — to show the possibility of pacing systems implantation (pacemaker, cardioverter defibrillator, cardiac resynchronization therapy) without indirect anticoagulant drugs abolition. Material and methods. Indirect anticoagulant therapy is usually discontinued in patients requiring any surgical procedures including pacemaker implantation to prevent hemorrhagic complications. In this study 46 patients with prosthetic heart valves who underwent pacing systems implantation on background of anticoagulants administration were reviewed. Cancellation of anticoagulants was extremely dangerous in them because of risk of thromboembolic complications. Correct understanding of volume of surgical intervention and adequate pacemaker implantation on background of anticoagulants administration allows to avoid hemorrhagic complications without risk of thromboembolism. Conclusions. Based on obtained results and analysis of foreign literature we can say that cancellation of anticoagulant therapy is not necessary before pacemaker implantation. Operations in our observation did not lead to severe bleeding and infectious complications. At the same time such serious complication as thromboembolic syndrome and thrombosis of heart valve prosthesis due to anticoagulant therapy cancellation is completely eliminated.