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Suicide Attempt by Self-Dissection of Permanent Pacemaker Leads
Hassan Masoom1, Nicholas M Berbenetz2, Justin Chow1
1Department of Medicine, Division of Cardiology, McMaster University, Hamilton, Ontario, Canada.
JACC. Case Reports
|July 28, 2021
Summary
A patient with depression attempted self-harm by severing pacemaker leads. This case underscores the need for psychiatric screening before device implantation and ongoing monitoring for self-harm risks.
Area of Science:
- Cardiology
- Psychiatry
- Medical Device Technology
Background:
- Permanent pacemaker implantation is a common procedure for managing cardiac arrhythmias.
- Patients with underlying psychiatric conditions may present unique challenges in managing implanted devices.
- Self-harm behaviors can pose significant risks to patients with medical devices.
Observation:
- A patient with diagnosed depression attempted suicide by intentionally damaging her permanent pacemaker leads.
- The self-dissection involved direct manipulation and severing of the implanted device components.
- This action led to a critical failure of the pacemaker's function.
Findings:
- The case demonstrates a rare but severe manifestation of self-harm in a patient with a permanent pacemaker.
- Psychiatric screening prior to pacemaker implantation is crucial for identifying at-risk individuals.
- Post-implantation surveillance for suicidal ideation and self-harm behaviors is essential.
Implications:
- Healthcare providers should integrate comprehensive psychiatric evaluations into the pre-implantation assessment for pacemakers.
- Routine follow-up should include screening for depression and suicidal behaviors in patients with implanted cardiac devices.
- Improved patient monitoring protocols can help prevent device-related self-harm incidents.