Pacemaker failure

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Pacemaker failure is the inability of an implanted artificial pacemaker to perform its intended function of regulating the beating of the heart. A pacemaker uses electrical impulses delivered by electrodes in order to contract the heart muscles. [1] Failure of a pacemaker is defined by the requirement of repeat surgical pacemaker-related procedures after the initial implantation. Most implanted pacemakers are dual chambered and have two leads, causing the implantation time to take longer because of this more complicated pacemaker system. These factors can contribute to an increased rate of complications which can lead to pacemaker failure. [2]

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Approximately 2.25 million pacemakers were implanted in the United States between 1990 and 2002, and of those pacemakers, about 8,834 were removed from patients because of device malfunction most commonly connected to generator abnormalities. [3] In the 1970s, results of an Oregon study indicated that 10% of implanted pacemakers failed within the first month. [4] Another study found that more than half of pacemaker complications occurred during the first 3 months after implantation. [2] Causes of pacemaker failure include lead related failure, unit malfunction, problems at the insertion site, failures related to exposure to high voltage electricity or high intensity microwaves, and a miscellaneous category (one patient had ventricular tachycardia when using his electric razor and another patient had persistent pacing of the diaphragm muscle). [4] Pacemaker malfunction has the ability to cause serious injury or death, but if detected early enough, patients can continue with their needed therapy once complications are resolved. [3]

Symptoms

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Causes

Direct factors

Indirect factors

Prevention

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Treatment

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See also

References

  1. McWilliam, John A. (1889-02-16). "Electrical Stimulation of the Heart in Man". Br Med J. 1 (1468): 348–350. doi:10.1136/bmj.1.1468.348. ISSN   0007-1447. PMC   2154721 . PMID   20752595.
  2. 1 2 3 4 5 6 Kiviniemi, Mikko S.; Pirnes, Markku A.; Eränen, H. Jaakko K.; Kettunen, Raimo V.j.; Hartikainen, Juha E.k. (1999-05-01). "Complications Related to Permanent Pacemaker Therapy". Pacing and Clinical Electrophysiology. 22 (5): 711–720. doi:10.1111/j.1540-8159.1999.tb00534.x. ISSN   1540-8159. PMID   10353129. S2CID   13076829.
  3. 1 2 "Pacemakers malfunction less often than defibrillators". AORN Journal. 82: 862. 2005 via Gale Health Reference Center Academic.
  4. 1 2 3 4 Reinhart, Steven; McAnulty J; Dobbs J (April 1981). "Type and timing of permanent pacemaker failure" . Chest. 81 (4): 433–5. doi:10.1378/chest.81.4.433. PMID   7067508 . Retrieved 2009-09-08.
  5. 1 2 3 4 5 6 7 8 Fuertes, Beatriz; Toquero, Jorge; Arroyo-Espliguero, Ramon; Lozano, Ignacio F (2003-10-01). "Pacemaker Lead Displacement: Mechanisms And Management". Indian Pacing and Electrophysiology Journal. 3 (4): 231–238. ISSN   0972-6292. PMC   1513524 . PMID   16943923.
  6. Salahuddin, Mohammad; Cader, Fathima Aaysha; Nasrin, Sahela; Chowdhury, Mashhud Zia (2016-01-01). "The pacemaker-twiddler's syndrome: an infrequent cause of pacemaker failure". BMC Research Notes. 9: 32. doi: 10.1186/s13104-015-1818-0 . ISSN   1756-0500. PMC   4721019 . PMID   26790626.
  7. 1 2 3 4 5 6 7 "Pacemakers". American Heart Association. Retrieved 6 April 2011.
  8. Miller, Reed (9 February 2011). "FDA approves first "MRI-safe" pacemaker". theheart.org. Retrieved 4 April 2011.