Subjective Consequences of Permanent Pacemaker Therapy in Patients Under the Age of Retirement

Abstract

During a 5-year period, 81 patients ages 20 to 60 years old had implantation of a permanent cardiac pacemaker at the University Hospital, Odense. At follow-up, during 1985, the 73 survivors received a semi-structured questionnaire regarding subjective consequences of pacemaker therapy, and 72 people (98.6%) agreed to participate. The mean pacing period (range) was 33.8 (11-72) months. Surgical intervention was required in 14 patients (19.4%) during follow-up. Regarding all symptoms 67 patients (93.1%) perceived benefit from the pacemaker. The effectiveness of cardiac pacing was most pronounced in subjects suffering from syncope and/or dizziness. Eight patients (11.1%) perceived anxiety most frequently due to fear of pacing failure. Physical complaints were present in 17 patients (23.6%), and the discomfort was mainly due to the size of generator, pain/tenderness from the scar or a sensation of "impulses"/palpitations. To the majority (49 patients or 68.1%) pacemaker treatment did not influence quality of sexual activity. Six patients (8.3%) perceived an improvement, whereas a corresponding number felt deterioration in sexual activity following pacemaker implantation. Pacemaker therapy had not affected life quality in 30 (41.7%) of the patients. However 31 patients (43%) felt an improvement, and only a minority of ten patients (13.9%) perceived deterioration in quality of life owed to pacemaker therapy.

Pacemaker Pocket Stabilization Utilizing a Novel Envelope and a Three-Point Anchoring Technique

“…While chronic indolent infection and regional pain syndromes are often considered and treated, generator movement within the pocket is often overlooked. Prior studies have shown that almost a quarter of patients undergoing CIED implantation report pain or discomfort with movement of the generator in the pocket [3]. Shoulder pain and limitation of movement ipsilateral to the CIED site are also common [4].…”

Sexual Activity and Cardiovascular Disease

“…61,62 Accordingly, sexual activity often decreases after ICD implantation. [62][63][64] The sexual partner is not believed to be at risk from defibrillation if the ICD discharges during sexual activity. 61,64 Stress testing may provide reassurance to the patient and spouse or partner that sexual activity is unlikely to precipitate or exacerbate arrhythmia.…”

Pacemaker Therapy: How do Patients Cope with the Icon of Modern Antibradycard Treatment?

“…The quality of life of pacemaker patients has been investigated by several authors using different criteria and instruments. After a mean pacing period of 34 months, 43% of the patients under the age of retirement showed an improvement of quality of life, 42% stayed unchanged and 14% felt a deterioration (self-developed questionnaire) (23). In a six-month study an overall of 80% of unselected pacemaker patients showed an improvement as rated by a Foulds' Personal Disturbance Scale (33).…”