Pregnancy in the presence of an implanted pacemaker

Two young females, who had implanted pacemakers, and experienced an uneventful course of pregnancy and delivery are described. We suggest the chest wall under the breasts as the site of choice for the implanted unit in young females who might expect pregnancy. If this site is used, any restriction of the skin above the unit should be prevented as the abdomen and breasts increase in size. The problem of a fixed heart rate during the period of an increasing work load on the heart in pregnancy is discussed, and the use in these patients of an adjustable-rate pulse-generators is suggested.