Permanent cardiac pacemaker: an emergency perspective

Correspondence to: Lam Chi Wang, MBChB, FRCS(Edin) Prince of Wales Hospita l , Accident and Emergency Department, Shatin, N.T., Hong Kong Email: [email protected] The number of patients with permanent pacemaker are increasing and may present into the emergency department with a variety of complications and malfunctions. The presence of a pacemaker may also affect management of unrelated medical issues. This article review the complications of the implant procedure, the causes, diagnosis and management of pacemaker malfunction, the pacemaker syndrome, Twiddler's syndrome. Interaction of permanent pacemaker with other medical condition and its implication in Emergency Department environment are also discussed. (Hong Kong j.emerg.med. 2001;8:169-175)