Study shows pacemakers not always permanent
Once a pacemaker is placed, it’s forever, right? Not necessarily, or at least not necessarily for every patient, says a recent study that draws into question the permanent need for cardiac pacing in certain patients.1
Pacemaker therapy was discontinued in a small set of patients for reasons related to battery replacement or pacing-related complications then not restarted. All patients were free of recurrent symptomatic bradycardia 18 to 48 months following removal. The patients had received their pacemakers for either a class I or II indication symptomatic bradycardia or persistent third-degree atrioventricular block at the level of the atrioventricular node.
The investigators write, "Discontinuation of cardiac pacing may be justified if clinical findings suggest that pacing is no longer indicated or that the risks of the continuous replacement of the device outweigh the potential benefits of implantation." Further study is needed to determine the best criteria, methods, and timing of the termination.
Reference
1. Iskos D, Lurie KG, Sakaguchi S, et al. Termination of implantable pacemaker therapy: Experience in five patients. Ann Intern Med 1997; 126:787-790.
Catherine Hamilton, RN, MPH, Clinical Coordinator, Heart ER, Center for Emergency Care, University of Cincinnati Medical Center. Telephone: (513) 558-5281.
Gregory W. Rouan, MD, Internist, University of Cincinnati Medical Center. Telephone: (513) 558-2590.
Jerri DeVaney, RN, BSN, Care Manager, Cardiac Service Line, St. Francis Hospital & Health Centers, Beech Grove, IN. Telephone: (317) 783-8358.
Kathy C. Fox, MSN, RN, Director, Cardiac Service Line, St. Francis Hospital & Health Centers, Beech Grove, IN. Telephone: (317) 783-8367.
Mary Hand, RN, MSPH, Coordinator, National Heart Attack Alert Program, National Heart, Lung, and Blood Institute, Rockville, MD. Telephone: (301) 251-1222.
Kent Hall, MD, Director, Heart ER, University of Cincinnati Medical Center. Telephone: (513) 558-5281.
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