BHF Medical Director Professor Peter Weissberg sets the story straight on pacemakers and implantable devices
You may have seen reports in the media this weekend on a recent study published in JAMA Internal Medicine which was led by Professor Zian Tseng at the University of San Francisco reporting concerns about the safety of pacemakers and other devices used to regulate the heartbeat such as implantable cardioverter defibrillators (ICDs), suggesting that a third of unexpected deaths among heart patients could be caused by faulty pacemakers and similar devices.
Given that more than a quarter of a million people in the UK have had a device fitted, it’s obviously crucial that we understand whether these findings have implications for heart patients in the UK.
What happens when you have a device fitted in the UK
There are a few things we need to take into account of when we look in detail at the study’s findings. The study was carried out in the USA where the choice of what device you receive and how closely you are followed up, may be different from the UK. This meansthat we cannot assume that the same results would have been obtained in the UK.
For patients with particular heart problems, a pacemaker or ICD can greatly improve quality of life and for some people it can be life saving.
Is my device putting me at an increased risk of dying?
In the UK, all ICDs and many permanent pacemakers are inserted because of a life-threatening condition that affects the heart rhythm. Without them, many thousands of patients would die. However, the more complex the device, the higher the risk of it occasionally failing to do the job it was designed to do.
I would like to reassure patients, however, that modern permanent pacemakers are extremely reliable and, provided they undergo regular checks (which is part of routine management in the UK). Problems such as sudden battery failure or wire fractures are extremely rare events
ICDs are more complicated than simple pacemakers and all patients with ICDs are at risk of sudden death without the device. That’s why they should be closely monitored and should have their devices regularly checked. Often the effectiveness of the ICD is determined by how sensitive its settings are. If the threshold for activating the device is too low, it can shock inappropriately and cause great distress to the patient; if it’s set too high, a potentially fatal rhythm disturbance may go untreated.
Should I be worried if I have an implanted device?
As with all medical interventions there are benefits and risks, and these vary from patient to patient. It’s therefore important that doctors are clearly explain what these risks and benefits are to each patient receiving one of these devices. In all patients where an ICD is recommended in the UK, the benefits far outweigh any risks.
It’s natural to feel worried about having a pacemaker or an ICD fitted and talking to an appropriately qualified healthcare professional is often preferable to worrying unnecessarily.
If you have any questions, talk to your doctor or call our Heart Helpline on 0300 330 3311 and speak with one of our cardiac nurses.