Indications

Pacing indications are provided by the American College of Cardiology and the American Heart Association (see "ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Summary Article," Circulation 2002;106:2145-2161).

 

Contraindications

1.1.  Generalities

There are no known contraindications to the use of cardiac pacemakers as a therapeutic method for controlling heart rate. Nevertheless, the patient's medical and physical condition, as well as age, should be taken into consideration when choosing the pacemaker and leads.

The benefits of pacing to pediatric subjects have not been evaluated. Adverse interactions may occur between the patient's spontaneous rate and pacemaker functions.

1.2.  Potential complications

Complications may arise with any implanted pacing system. They may be related to the device itself:
Early battery depletion
Component failure
Circuit inhibition, reversion to standby mode, or other failures due to electromagnetic interference
Pectoral stimulation
Complications may be related to the pacing leads:
Poor connection to the pacemaker leads
Lead displacement, cardiac wall perforation, or tissue reaction at the myocardium-electrode interface
Insulation fracture
Conductor fracture
Medical complications may also arise:
Infection
Fluid accumulation at the implant site
Casing migration
Skin erosion by the pacemaker with possible protrusion of the casing