Safety seat belt use in Japanese patients with a pacemaker

The aim of this study was to evaluate whether the rate of seat belt use is influenced by the interaction between the seat belt shoulder strap and pacemaker generator. The participants (1,942 Japanese patients with pacemakers) were asked to respond to a questionnaire about their seating position in the vehicle, their actual use of seat belts, and the reasons for not wearing seat belts. Front seat occupants (drivers and front seat passengers) were divided into two groups according to the relation between the site of the seat belt shoulder strap and the pacemaker implantation site: group-1--seat belt ipsilateral to the pacemaker, and group-2--seat belts contralateral to the pacemaker. Of the 1,942 questionnaires sent by mail, 1,486 (76.5%) were completed and returned. The actual rates of seat belt use were as follows: drivers (n = 428), 67.4% in group 1 versus 81.0% in group 2 (P < 0.01):front seat passengers (n = 403), 63.7% in group 1 versus 70.1 % in group 2 (NS); rear seat passengers (n = 655), 26.6%. Among the front seat occupants, pain or an uncomfortable sensation were stated in 59.0% of group 1 versus 30.7% of group 2 (P < 0.01). The interaction between seat belts and pacemaker lowers the rate of seat belt use in patients with pacemakers. Pain or discomfort from seat belt-pacemaker contact was noted as the reason for not wearing a seat belt. Physicians should inquire about and take into account a patient's seating location in the vehicle and the location of the seat belt shoulder restraint. The pacemaker implantation site should be placed, if possible, contralateral to the seat belt.