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Pacemaker Failure

Pacemakers are reliable life-saving devices, but problems do rarely occur. It is important to understand why you have a pacemaker. This can also help you understand why it might "fail." These are some reasons you may have a pacemaker:

  • To help increase your heart rate if it is too slow

  • Heart block

  • Damage to the part of the heart controlling the heart rhythm due to a heart attack

  • A fast, irregular heart rate that requires medicine or procedures that result in a heart rate that is too slow

Signs and symptoms of pacemaker failure or malfunction include:

  • Dizziness, lightheaded

  • Fainting or loss of consciousness

  • Palpitations

  • Hard time breathing

  • Slow or fast heart rate, or a combination of both

  • Constant twitching of muscles in the chest or abdomen

  • Frequent hiccups

A complete failure of a modern pacemaker is rare. Most of the time, "malfunction" of a pacemaker means it is working normally, but may need to be reprogrammed. Other times, there might be a problem with the battery, a lead, or an electrode.

Causes for a pacemaker failure include:

  • Battery depletion

  • Loose or broken wire between the pacemaker and the heart

  • Electronic circuit failure

  • Electrolyte abnormality (such as high potassium in the blood)

  • Electromagnetic interference from certain devices such as power generators, arc welders, and powerful magnets (found  in medical devices, heavy equipment, and motors)

  • A pacemaker lead gets pulled out of position

  • A change in your condition that needs pacemaker reprogramming

NOTE: Common household devices, such as microwave ovens, TV remotes, heating pads, and electric blankets, don't interfere with pacemakers. Cell phones in the U.S. do not interfere with pacemakers, but it is recommended that you keep a cell phone on the opposite side of the body from the pacemaker. Some devices are not affected by MRI (magnetic resonance imaging), but talk with your healthcare provider to know if you can safely have an MRI with your device and if you should take any special precautions first.

Home care

The following are general care guidelines:

  • Don't push, pull, or twist the pulse generator unit placed under your skin.

  • Carry a wallet I.D. card with the name of your device and its maker, and the name of your cardiologist. This will help emergency personnel test your pacemaker in the event of a malfunction.

  • Medical and dental equipment can affect pacemakers. Tell the doctor or dentist that you have one before any procedures are done. Routine X-rays will not affect a pacemaker.

Follow-up care

Follow up with your doctor, or as advised.

Have your battery checked at least every 6 months, or as advised by your healthcare provider, to make sure your battery does not become depleted. The generator will need to be changed once the device has reached the end of its' battery life, which is about every 5 to 7 years, depending on how much your heart uses the device. Monitoring of the device function and battery strength can sometimes be done using a device connected to your phone line. Or you may be able to  transmit information to your healthcare provider over the internet. Ask your provider if this is an option for you.

Call 911

Call 911 if you have any of the following:

  • Trouble breathing

  • Fainting or loss of consciousness

  • Chest pain

  • Frequent or persistent palpitations (the sense that your heart is fluttering or beating fast or hard or irregularly)

  • Slower than usual heart rate compared to your normal

  • Chest pain with weakness, dizziness, fainting, heavy sweating, nausea, or vomiting

  • Extreme drowsiness, confusion

When to seek medical advice

Get prompt medical attention if any of the following occur:

  • Weakness, dizziness, lightheadedness

  • Pain, redness, swelling, or drainage from pacemaker implant site

  • Fever above 100.4°F (38°C) or other signs of infection (redness, swelling, drainage, or warmth at the incision site)

  • If your pacemaker generator feels loose or like it is wiggling in the pocket under the skin

  • If you have muscle twitching in your chest or abdomen muscles

  • Hiccups that won't stop


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