Pacemaker is a safe medical device with a low risk of complications. Some of the risks of pacemaker implantation include complications during or after pacemaker surgery, infection of the pacemaker, and pacemaker malfunction.
Pacemaker is a major advance in the management of problems with rate and rhythm of the heart. It is a device which can monitor the heart’s rate (how fast it beats) and rhythm (the pattern in which it beats) and correct any abnormality of rate or rhythm by electrical stimulation of the heart. It is implanted surgically in the chest or abdomen. It is a safe device which has saved millions of lives but like any other invasive device or procedure pacemaker has risks as well as benefits. Some of the risks of pacemaker implantation are described below.
Risks of Pacemaker Surgery
The risk of developing complications after pacemaker surgery is very lowh, especially if it is performed by an experienced doctor at a good health care facility. Some of the problems which may occur include:
- swelling, bleeding, bruising, or infection at the site of pacemaker insertion (place where pacemaker is placed)
- injury to adjacent blood vessel or nerve
- injury to lungs (this can cause collapse of the lung or pneumothorax)
- allergic reaction to the medicine used during the procedure.
Pacemaker is inserted in a complete sterile and aseptic manner, but there is a small risk of infection. The site of the pacemaker, implantable caridoverter defibrillator (ICD) or their leads may get infected. According to estimates around 1 in 100 people with a pacemaker experience infection after pacemaker insertion. In most cases the infection develops within the first 12 months of having a pacemaker fitted.
Signs and symptoms suggestive of a pacemaker infection include:
- fever (temperature of 380C or 100.40F or above) for more than a few days
- pain, swelling, redness or fluid discharge at the site of the pacemaker
If you have any symptom suggestive of pacemaker infection, consult your cardiologist (a doctor who specialises in the diagnosis and management of heart disease) as soon as possible for advice. Pacemaker infection is usually treated aggressively using a combination of broad spectrum antibiotics. The antibiotic coverage may be modified in a few days when the results of culture and sensitivity become available. In addition, the doctor may remove the pacemaker and then replace it. If the infection is not treated timely and appropriately it can progress and spread into your lungs (pneumonia), the lining of your heart (endocarditis) or your blood (blood poisoning or sepsis).
As with any electronic device, the pacemaker can also malfunction or stop working properly, although the risk is low. According to studies around 1 in every 250 people with a pacemaker, experience pacemaker malfunction.
Pacemaker can stop working properly if:
- any of its lead gets pulled out of position
- the battery, which powers the pulse generator fails
- circuits which control the pacemaker are damaged because of exposure to strong magnetic fields
- the pacemaker is not programmed properly.
Some signs and symptoms suggestive of pacemaker malfunction include:
- your heart starts to beat more slowly or quickly
- you feel dizzy or lightheaded
- you feel faint or nearly faint.
If you have any concerns regarding your pacemaker function seek immediate medical advice.
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