OBJECTIVES Men’s and Women’s health care experiences differ as they age. These differences lead to disparate health and treatment outcomes between the genders, especially in the area of cardiac health, which has significant disease burden in the US. Women experience symptoms that ‘deviate’ from the ones found in a clinician’s guidebook. The emergency room (ER) also serves as a medical space for initial diagnosis of heart conditions. Thus, looking at the gender based use of ER prior to a cardiac event may help us understand the disparities from a systems perspective. Cardiac pacemakers are used to treat severe and/or symptomatic bradycardia, heart block or a combination of both. This study explored gender differences in characteristics and ER diagnoses associated with pacemaker implants in an inpatient setting. METHODS The study used data from the inpatient and emergency room hospital discharge data from the Florida HealthCare Utilization Project for years 2009 and 2010. Patients with a primary insertion of initial pacemaker and with a diagnosis of bradycardia or heart block or both were included. A unique patient identifier helped map patients across the inpatient and emergency settings. Descriptive statistics were used to look at items of interest. RESULTS There were 1403 discharges meeting the inclusion criterion. These were linked to 1402 ER discharges previous to the surgery. There were no significant differences between the genders in terms of characteristics like race, primary payer, age, etc. However, more men had ER visits than women (52.43% vs 47.57%). The top diagnosis in the ER consisted of conduction disorders (21.03%). Syncope occurred in 10.05% of discharges. Atrial fibrillation was the only ER diagnosis which women experienced more than men. CONCLUSIONS The findings of the study were inconclusive in showing significant differences between the genders in terms of characteristics and ER diagnosis among recipients of primary pacemaker.