Pacemaker Complications

Perforation

Effusion/tamp/pain Typically acute, consider if HoTN

Failure to pace

Bradycardia ↓ Battery, lead fx/dislodgment, ↑ pacing threshold due to tissue rxn/injury; oversense → inapprop. inhib

Failure to sense

Inapprop. pacing Lead dislodgment or sensing threshold too high

PM-mediated tachycardia

WCT at device upper rate Seen w/ DDD. V → A retrograde conduction; sensed by A lead → triggers V pacing → etc.

PM syndrome

Palpit, HF Seen w/ VVI, due to loss of AV synchrony