Hazards of cardiac pacing

The implantation of a cardiac pacemaker is now widely accepted as the preferred method of therapy for heartblock, and is increasingly used for treatment of other cardiac abnormalities. Many thousands of pacemakers have been implanted since 1960. Some of the problems which arise from such implants are not urgent and are in the "low risk" category, whilst others require immediate remedial action. The hazards which are discussed are based on experience in Glasgow with over 500 pacemaker patients, over two thirds of whom are currently attending pacemaker clinics. If all pacemaker patients are to derive maximum benefit from their implants with minimum inconvenience and risk, there is a need for continued vigilance and better technology. There is also a need for retrieval of all pacemakers after death to confirm that death has not arisen from any of the technical faults which can place the lives of certain patients at great risk.