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Published on: February 26, 2013
Termination of implantable pacemaker therapy: experience in five patients
D Iskos1, K G Lurie, S Sakaguchi
1University of Minnesota Medical School, Minneapolis, USA.
Annals of Internal Medicine
|May 15, 1997
Summary
Pacemaker removal is feasible and safe in selected patients, even after long-term use. Discontinuation of cardiac pacing can be considered when the original indication resolves.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Established guidelines exist for pacemaker implantation and elective replacement.
- No current guidelines address the removal of permanent pacemakers or cessation of long-term cardiac pacing.
- Pacemaker dependency is often assumed, limiting consideration for device removal.
Observation:
- A case series involving five adult patients referred for pacemaker replacement or complication.
- All patients had pacemakers implanted for symptomatic bradycardia or AV block.
- Patients demonstrated resolution or reversal of the original electrical disturbance.
Findings:
- Pacemakers were successfully removed after documentation of a stable natural rhythm.
- No patient experienced recurrent symptomatic bradycardia during 18-48 months of follow-up.
- This suggests that long-term cardiac pacing may not always be necessary.
Implications:
- Permanent pacemakers do not always indicate a permanent need for pacing.
- Discontinuation of cardiac pacing is a viable option for carefully selected patients.
- Development of consensus criteria for pacemaker removal indications, methods, and timing is warranted.
