Pacemaker Complications

Pacemakers regulate irregular heartbeats, but they can lead to various complications. Infection at the implant site affects around 1% of patients, typically within the first year, causing fever, redness, swelling, or pain; untreated, it may spread to the lungs (pneumonia), heart lining (endocarditis), or bloodstream (sepsis). Blood clots form in 2% of cases, usually in the arm vein near the device, leading to temporary swelling that resolves quickly.

Procedural risks include pneumothorax (1%), where the lung is punctured, allowing air leakage into the chest; small leaks heal spontaneously, but larger ones require drainage. Lead dislodgement or fracture disrupts pacing, causing dizziness, palpitations, fainting, or irregular rhythms. Device malfunction, though rare, stems from battery depletion (after 5-15 years), lead displacement, electromagnetic interference, or programming errors, manifesting as slow/fast heartbeats or hiccups.

Other issues encompass allergic reactions to device materials, pericarditis, or Twiddler's syndrome from subconscious device manipulation. Regular check-ups and symptom vigilance minimize risks; seek immediate care for concerning signs. Advances in leadless pacemakers reduce some issues.