What is Pacemaker Syndrome?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 07 September 2019
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Pacemaker syndrome is a possible complication of the use of a mechanical pacemaker where a patient's heart beats out of synch, leading to decreased cardiac output. It is an example of an iatrogenic medical condition, a problem caused by medical intervention. When a patient is diagnosed with pacemaker syndrome, there are several treatment options available, including adjusting the programming of the pacemaker.

When a mechanical pacemaker is implanted, it controls the heart rhythm with a series of electrical signals. These devices are used when a patient's heartbeat is irregular and the patient is at risk of health problems. In some patients, the pacemaker causes the ventricles to contract before the atria, effectively asking the heart to beat in reverse and forcing blood against the closed valves between the chambers of the heart. This makes the heart work harder and leads to pacemaker syndrome.

Patients with pacemaker syndrome can experience shortness of breath, fainting, and a pounding feeling in the chest. The symptoms are variable and are sometimes confused with other medical problems. This condition tends to resist recognition by a doctor, unless a patient has a history that suggests he might be at risk of pacemaker syndrome. People with slow heart rates, for example, are more likely to develop this condition when a pacemaker is installed.


One option for managing pacemaker syndrome is to adjust the pacing to see if the heart can be brought back into synchronization. If this does not work and a patient only has ventricular pacing, a second lead may be attached to pace the beating of the atria as well. This should resolve the problem. Some patients also experience benefits when they modify their diets to reduce blood pressure and promote cardiovascular health.

A cardiologist is usually needed to accurately identify and diagnose pacemaker syndrome. This medical specialist can request an electrocardiogram to learn more about how the heart is beating, as well as listening to the heart and ordering some heart function tests, looking for issues like decreased cardiac output that suggest a patient may have pacemaker syndrome. When spotted early, this condition should not cause complications for the patient.

Improper pacing is one of the potential risks of permanent heart pacing. Patients should be attentive to changes in their heart rate, as well as symptoms of cardiovascular problems, so they can see a doctor promptly if early warning signs of complications or new medical issues develop while using a pacemaker.


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