What if you woke up in a hospital and found out your mortal enemy had surgically removed your face and glued it onto his own and now he was out in the world pretending to be you? Living your life, hanging with all your friends, doing all your drugs, having all your fun?

You’d probably be pretty upset. Maybe even attack him with a spear gun.

 

What if you woke up in a hospital with a pacemaker implanted in your chest? You’d probably just want to know a little bit more about how they work.

To start, what's the difference between a pacemaker and an Implantable Cardio-Defibrillator (ICD)

 

How are pacemakers categorized?

 

What are some complications arising from pacemakers?

What can be done in the ED for questionable pacemaker malfunction?

 

In conclusion, pacemakers and ICDs are relatively straightforward once you understand their basic functions. Troubleshooting will require a good physical exam, an ECG, a chest X-ray, and possibly pacemaker interrogation by the device manufacturer or cardiology. Troubleshooting how to get your face back from your mortal enemy will typically require more… aggressive measures.

Read more on Cardiology topics in Emergency Medicine here.

Piktel JS. Chapter 22. Cardiac Rhythm Disturbances. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7e New York, NY: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com.newproxy.downstate.edu/Content.aspx?bookid=348&sectionid=40381483. Accessed June 12, 2017.

Beyerbach, Daniel. Pacemakers and Implantable Cardioverter-Defibrillators. E-Medicine, Medscape. http://emedicine.medscape.com/article/162245

Bernstein AD, Daubert JC, Fletcher RD, et al. The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. North American Society of Pacing and Electrophysiology/British Pacing and Electrophysiology Group. Pacing Clin Electrophysiol 2002;25:260–264

Martindale, J and deSouza, IS. Managing Pacemaker-Related Complications and Malfunctions In The Emergency Department. Emergency Medicine Practice

ECG obtained from: https://lifeinthefastlane.com/table/ecg-database

X-Rays obtained from: https://radiopaedia.org

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