Specialty emergency medicine | ICD-10 T82.1 | |
Pacemaker failure is the inability of an implanted artificial pacemaker to contract the heart muscles using electrical impulses delivered by electrodes in order to regulate the beating of the heart. Failure of a pacemaker is defined by the requirement of repeat surgical pacemaker-related procedures after the initial implantation. Most implanted pacemakers are dual chambered and have two leads, causing the implantation time to take longer because of this more complicated pacemaker system. These factors can contribute to an increased rate of complications which can lead to pacemaker failure. Approximately 2.25 million pacemakers were implanted in the United States between 1990 and 2002, and of those pacemakers, about 8,834 were removed from patients because of device malfunction most commonly connected to generator abnormalities. A study of pacemaker failure in Oregon in the 1970s indicated that 10% of implanted pacemakers failed within the first month. Causes of pacemaker failure included lead related failure (lead migration, lead fracture, ventricular perforation), unit malfunction (battery failure or component malfunction), problems at the insertion site (infections, tissue breakdown, battery pack migration), failures related to exposure to high voltage electricity or high intensity microwaves, and a miscellaneous category (one patient had ventricular tachycardia when using his electric razor and another patient had persistent pacing of the diaphragm muscle). Pacemaker malfunction has the ability to cause serious injury or death, but if detected early enough, patients are able to continue with their needed therapy once complications are resolved.