Pacemaker problems can rarely occur long after the implantation procedure. These "late" complications include generator failure (extremely rare), and lead failure (less rare). Lead failure can occur if the pacemaker is traumatized somehow, such as from the wear and tear of movement. (The most common cause of such trauma is the habit some people have of “twiddling” with their pacemaker.) Manufacturers are required to report device failures to the FDA. which will order companies to issue either "advisories" or recalls if a particular model seems prone to failure.
Following the suggested maintenance schedule usually means that pacemaker problems will be detected before they become serious. However, it is important for patients to be aware of the symptoms of bradycardia, symptoms that might indicate a pacemaker malfunction. Once again, these symptoms include weakness, easy fatigability, lightheadedness, dizziness, or loss of consciousness. Patients experiencing any of these symptoms should notify their doctor. A simple telephone check of the pacemaker is usually enough to rule out a pacemaker problem.
What devices can interfere with pacemakers?
Home appliances do not interfere with pacemakers, and should not cause any concern whatsoever. (This includes microwave ovens, despite the signs you still see posted in some restaurants.)Arc welding equipment and other devices that generate powerful magnetic fields – medical devices and heavy duty industrial motors – can inhibit the function of pacemakers.
Cellular telephones, if held in close proximity to the pacemaker (which may happen if the phone is kept in a breast pocket) can potentially affect the function of a pacemaker. As long as the phone is kept 6 or more inches from the pacemaker there should not be a problem.
MRI scanners can interrupt the pacing function of pacemakers, and under some circumstances may be dangerous to the pacemaker and the patient. Many problems with MRI can be circumvented by taking special care during the procedure and limiting the MRI scan appropriately. Patients with pacemakers should discuss the risks and benefits of MRI scanning with their doctors.
Radiation therapy for cancers can damage the circuits of a pacemaker, and the pacemaker needs to be shielded from the radiation field.
Shock wave lithotripsy, used to break up kidney stones, can potentially damage pacemakers, especially if they are implanted in the abdomen instead of under the collarbone. Pacemakers should be tested after lithotripsy to document that they are still functioning normally.
