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Pacemaker and Angioplasty Complications

Pacemakers:

  • infection at implant site
  • swelling/bruising/bleeding (hematomas) at the generator site, especially if taking blood thinners
  • allergic reaction to dye/anesthesia
  • damage to blood vessels/nerves near pacemaker
  • collapsed lung ← pneumothorax, hemothorax
  • puncture of myocardium → tamponade, pericarditis
  • air emboli
  • erosion of pacer through the skin (rare)
  • venous thrombosis (rare)
  • pacemaker (pm) syndrome
    • fatigue, dizziness, HoTN, palpitations, syncope, pulsation and fullness in the neck (elevated JVP)
    • VVI pm, especially in SA disease
    • loss of AV synchrony (atria and paced ventricles contract at the same time)
    • retrograde VA conduction
  • pm malfunction
    • failure to output – no pacing spike ← battery failure, break in lead/lead insulation, oversensing, bad lead connection, “cross talk” (ventricular lead senses atrial output)
    • failure to capture – pacing spike not followed by atrial/ventricular complex ← lead fracture/dislodgement, break in lead insulation, high pacing threshold, MI at lead tip, drugs, metabolic/electrolyte abnormalities, cardiac perforation, bad lead connection, improper settings
    • oversensing – senses inappropriate electrical activity, i.e. diaphragm/pectoralis mm. movement or electromagnetic interference → inhibits correct pacing
    • undersensing – misses intrinsic depolarization → paces despite intrinsic activity ← bad lead position/dislodgement, low battery, magnet, MI
    • tachycardia

Angioplasty (Percutaneous Coronary Intervention):

  • discomfort and bleeding at puncture site (most common)
  • restenosis (30% angio alone, 20% bare metal stents, 10% drug-eluting stents)
  • if stent used → blood clots
  • allergic reaction or kidney damage from dye
  • arrhythmia
  • dissection of internal layer of coronary artery (rare)
    • may heal on its own
    • may require stent
    • may require urgent CABG
    • if severe, may block blood flow in artery or loss of blood around heart
  • heart attack (rare)
  • stroke (extremely rare)

Sources:

http://www.mayoclinic.org/tests-procedures/pacemaker/basics/risks/prc-20014279

http://www.patient.co.uk/doctor/pacemaker-syndrome-and-pacemaker-complications

http://www.uptodate.com/contents/heart-stents-and-angioplasty-beyond-the-basics#H11

http://www.nhlbi.nih.gov/health/health-topics/topics/angioplasty/risks.html

http://www.mayoclinic.org/tests-procedures/angioplasty/basics/risks/prc-20014401

 

 

Dr. Ben-Zur is a highly revered cardiologist and electrophysiologist who treats various heart conditions, including atrial fibrillation, a-fib, AF, arrhythmias, valvular disease, congestive heart failure, and many more. He services patients from Burbank, Sherman Oaks, Encino, Hollywood and beyond. He places pacemakers, implantable defibrillators and can help provide any information that you may need regarding these procedures.

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