Risks Of A Cardiac Pacemaker
Medical advancements, such as a cardiac pacemaker, have led to solutions for frequently encountered heart problems like bradycardia, stroke, cardiac failure, atrial fibrillations, or arrhythmias. However, as beneficial and life-saving a pacemaker seems, every medical procedure brings along some risks and limitations.
When it comes to a pacemaker implant, the patient becomes susceptible to certain perils such as damage to the veins, thrombosis, hematoma, infections, or pacemaker malfunctions in the device. These risks, being temporary, can easily be overcome in the hospital; however, as a patient, it is advisable to be well-aware of any kind of hazard at all times.
Overview of Risk Statistics
Pacemaker complications generally depend on the degree of damage to heart tissue. If you have a biventricular pacemaker, the chances of facing a problem significantly increase. But the complications are no less for a single chamber pacemaker in comparison to the dual-chamber pacing. Moreover, according to research, patients over 70 years normally face fewer complications after an implant. A general overview regarding the rate of complications shows that only 1-6% of the patients face major troubles after the pacemaker is inserted in their body. Around 1 out of 10 patients show signs of pacemaker complications due to the device or lead dislodging. Infection or hematoma has been seen to occur in only 5% to 6% of the patients.
Common Risks and Complications
After being through the entire surgical procedure, it is important to stay alert for any kind of abnormality that you may feel. Within the first few weeks, essential care is necessary, and you must contact your doctor if you feel fatigued, dizzy, allergic, have breathing difficulties, gained weight, or if your legs and ankles swell up. These signs may indicate a risk factor associated with your implant procedure.
A summary of some common complications due to a cardiac pacemaker is given below.
1. Damaged Vessels
The most likely of all pacemaker complications are bleeding, which generally occurs at the site of insertion. This is also known as pocket hematoma accompanied by infection, discomfort, pain, and palpable swelling at the site where the pulse generator is located. Using anticoagulants during the surgery leads to an increased bleeding tendency from the blood vessels.
Also, an incision to a vessel during surgery while placing the pacemaker may cause blood loss. This bleeding condition is typically controlled by medications and blood coagulants. Apart from hematoma formation, sometimes the blood vessels can also develop thrombosis or a clot in them. Clotting is seen in the arm near to the point where the pacemaker is inserted. This is generally the body’s reaction and subsides within a few days.
2. Infection
Pacemaker infections are a serious problem observed along with pain, edema, redness, swelling, and high temperature at the site. An invasive procedure of implanting the pacemaker calls for a frequent occurrence of infections by bacteria. The site of infection may vary, either in the generator, lead wires, or even in the heart muscle. However, deep infections are much more serious that can lead to endocarditis and require another surgery to remove and reposition the pacemaker followed by antibiotics therapy, in case of infection developed at the surgical site, it is recommended to reposition the cardiac pacemaker at an alternate site.
3.Pneumothorax
Pneumothorax is a medical term for air leaking into the chest cavity of the patient. A cardiac pacemaker is inserted in the chest cavity where several vital body organs are also situated, including the heart, the lungs, and some major blood vessels. In some cases, the lead wires can cause a puncture in the lungs due to over-crowding in the chest cavity. Hence, a punctured lung causes leakage of air in the chest. This is indicated by sudden chest pain, respiratory distress, shortness of breath, subclavian puncture, and sudden hypotension. Pneumothorax must be treated immediately by withdrawing air out of the chest and sealing the lung puncture.
4. Pacemaker Malfunction
Being an artificial device, the pacemaker machinery may also be at fault and stop working suddenly. This condition may result from a problem in the plugging of lead wires, the battery of the pulse generator, or programming issues in the computer system of the cardiac pacemaker. Exposure to strong magnetic fields can also interfere with the normal functioning of the device. Such malfunctioning can greatly affect the working of your pacemaker. It may lead to an abnormal discharge of electrical impulses that ultimately causes tachycardia, dysrhythmias, ventricular fibrillation, dizziness, and fainting. Hence it is important to select an advanced pacemaker that is fully functional and rate-responsive.
5. Lead Dislodging
If the lead wires are not properly embedded in the endocardium of the heart, it may fail the transmission of impulses to the heart. Hence the lead wires must be in tight physical contact with the heart so that the wires are not displaced even by slight movements. Lead dislodgement is linked to the movement of the arms, so an outward arm motion can cause the coiling of the wire around the generator in case the wires are not plugged properly. Muscle twitching or syncope may arise in such circumstances.
Another case of lead dislodging is Twiddler’s syndrome, which is due to the rotating and twisting of the pulse generator in its pocket. As a result, the lead wires also become coiled and twisted. A surgical procedure is required to untangle the lead wires and reposition the generator within its pocket.
Vigilant monitoring with South Florida CardioVascular Specialists
Based on the fact that the pacemaker implant comes with temporary complications, you must be vigilant to monitor yourself closely at all times. Don’t hesitate to have a detailed conversation with your doctor, because at South Florida CardioVascular Specialists, you are guaranteed to get expert advice from a panel of doctors. Your life is our number one priority, and we work to ensure that your life quality even after a pacemaker implant is as problem-free and smooth as possible.
