From the Guidelines
To fix a pacemaker, you should immediately contact your cardiologist or go to the emergency room if you're experiencing symptoms like dizziness, fainting, or chest pain, as these may indicate pacemaker malfunction. Do not attempt to repair a pacemaker yourself as it requires specialized medical expertise 1. Pacemaker issues typically require professional intervention by a cardiac electrophysiologist who can perform diagnostic tests to identify the problem.
Common Fixes
- Reprogramming the device
- Replacing the battery (typically needed every 5-15 years depending on the model and usage)
- Addressing lead displacement or fracture through a surgical procedure 1. Regular check-ups every 3-6 months are essential for preventive maintenance, and many modern pacemakers can be monitored remotely. If you have a pacemaker, always carry your device identification card, avoid strong electromagnetic fields, and report any unusual symptoms promptly.
Discontinuation of Pacemaker Therapy
In patients who present for pacemaker pulse generator replacement, or for management of pacemaker-related complications, in whom the original pacing indication has resolved or is in question, discontinuation of pacemaker therapy is reasonable after evaluation of symptoms during a period of monitoring while pacing therapy is off 1. Pacemakers are sophisticated electronic devices implanted to regulate heart rhythm by delivering electrical impulses when the heart's natural electrical system malfunctions, and only qualified medical professionals should handle their repair or adjustment.
From the Research
Pacemaker Malfunction
- Pacemaker malfunction refers to a failure of the pacemaker to perform the desired cardiac pacemaking function, which can occur anywhere within the system from the pulse generator and leads to the electrode-myocardium interface 2.
- These malfunctions can result in failures of sensing, capture, and inadequate pacing, leading to severe hemodynamic consequences, making rapid identification of specific dysfunction critical to intervention and stabilization 2.
Prevention of Infections
- Systemic and localized infections related to permanent pacemaker implantation are not common but are serious and potentially life-threatening complications 3.
- A single, intravenous 2 g dose of cefazolin has been shown to be safe and effective in preventing infective complications related to pacemaker implantation or replacement 3.
- Combination antibiotic prophylaxis, such as the use of rifampin with cefazolin or vancomycin, may further reduce infectious complications 4.
Management of Complications
- Patients with pacemaker-related complications and malfunctions require a clinical approach that includes electrocardiographic diagnosis and consideration of potential sources of electromagnetic interference 5.
- Perioperative anticoagulation management is a common clinical problem in patients having implantation of a pacemaker or implantable cardioverter defibrillator, and strategies such as interruption of a coumarin and use of bridging anticoagulation with a short-acting heparin or perioperative continuation of a coumarin have been assessed 6.