Pacemaker Failure

Pacemakers are reliable life-saving devices, but problems do rarely occur. It is important to understand why you have a pacemaker. This can also help you understand why it might "fail."

Some reasons you may have a pacemaker include:

• To help increase your heart rate if it is too slow
• Heart block
• Damage to the part of the heart controlling the heart rhythm because of a heart attack
• A fast, irregular heart rate that requires medicine or procedures that result in a heart rate that is too slow
• Signs and symptoms of pacemaker failure or malfunction include:
• Dizziness, lightheadedness
• Fainting or loss of consciousness
• Palpitations
• Hard time breathing
• Slow or fast heart rate, or a combination of both
• Constant twitching of muscles in the chest or abdomen
• Frequent hiccups

A complete failure of a modern pacemaker is rare. Most of the time, "malfunction" of a pacemaker means it is working normally, but may need to be reprogrammed. Other times, there might be a problem with the battery, a lead, or an electrode.

Causes for a pacemaker failure include:

• Battery depletion
• Loose or broken wire between the pacemaker and the heart
• Electronic circuit failure
• Electrolyte abnormality (such as high potassium in the blood)
• Electromagnetic interference from certain devices such as power generators, arc welders, and powerful magnets (found  in medical devices, heavy equipment, and motors)
• A pacemaker lead gets pulled out of position
• A change in your condition that needs pacemaker reprogramming

Common household devices, such as microwave ovens, TV remotes, heating pads, and electric blankets, do not interfere with pacemakers. Cell phones in the U.S. do not interfere with pacemakers, but it is recommended that you keep a cell phone on the opposite side of the body from the pacemaker. Some devices are not affected by MRI, but talk with your healthcare provider to know if you can safely have an MRI with your device and if you should take any special precautions first.

Home care

The following are general care guidelines:

• Do not push, pull, or twist the pulse generator unit placed under your skin.
• Carry a wallet ID card with the name of your device and its maker, and the name of your cardiologist. This will help emergency personnel test your pacemaker in the event of a malfunction.
• Medical and dental equipment can affect pacemakers. Tell the healthcare provider or dentist that you have one before any procedures are done. Routine X-rays will not affect a pacemaker.

Follow-up care

Follow up with your healthcare provider as advised:

• Pacemakers are monitored remotely every 3-4 months
• Follow up visits in the healthcare provider's office for device check is yearly unless otherwise indicated by your provider
• The generator will need to be changed once the device has reached the end of its battery life, which is about every 5 to 7 years, depending on how much your heart uses the device.
• You may be able to transmit information to your healthcare provider over the internet. Ask your provider if this is an option for you.

© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.