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The most common pacemaker risks are infection at the pacemaker site, bleeding or bruising, bad reactions to anesthesia, and implantation of a faulty pacemaker. These risks are still quite low, especially in a reputable medical facility. More rare pacemaker risks include collapsed lung, a puncture of the pericardial sac, and dislodgement of the pacemaker or faulty initial placement leading to problems in the future. These complications may require surgical treatment.
A pacemaker is a small device inserted into a patient's chest to regulate the heartbeat. It includes leads connected to the heart, along with a small generator. The surgery to implant the pacemaker may be performed under general, regional, or local anesthesia, and is done by a surgeon with the assistance of a radiologist to help place the leads properly. Usually, the concerns associated with pacemaker implantation are deemed less serious than the risks of not using the pacemaker at all and the pacemaker risks are carefully evaluated on an individual basis before recommending the surgery.
Infections can occur even when control of the surgical site is very tight, as sometimes skin bacteria enters the wound or contaminants are accidentally introduced with tools. People who notice heat, tenderness, or swelling after pacemaker implantation should tell the surgeon and receive an evaluation for infection. Patients on bloodthinners in particular are at risk of some localized bruising and bleeding when a pacemaker is installed.
Adverse reactions to anesthesia are also unusual, as patients are screened carefully for any obvious risk factors, but they can happen. Likewise, patients can also experience a reaction to the tracer dye used by the radiologist to help guide the surgeon. The other common pacemaker risk, involving the implantation of a faulty device, is also relatively unusual. These devices are rigorously tested before installation to avoid situations where surgeons need to return to put in a new pacemaker.
Of the more rare pacemaker risks, punctured lungs and pericardial sacs sometimes occur if the radiologist and surgeon don't coordinate, the patient has especially friable tissue, or something goes wrong during the procedure. Likewise, poor placement of the device is unusual, but sometimes occurs, and sometimes patients dislodge the device or the leads during vigorous activity following surgery.
When a pacemaker is recommended for a patient, the surgeon should go over the pacemaker risks and the warning signs of complications so the patient can take action promptly if a problem develops. Generally, patients with pacemakers do not experience problems and can return to a normal level of physical activity after they recover from surgery.