Pacemaker patients' perception of unsafe activities: a survey

A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded.The final sample included 93 adult patients (45% males). 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%), passing through metal detectors (31%), bending over (37%), and sleeping on the side of the pacemaker (30%). Also considered unsafe were operation of household appliances- TV/VCR (television/video cassette recorders) (53%), irons (55%)) and electrical wall switches (56%).For nearly all variables neither literacy nor history of counselling improved incorrect perceptions.This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these problems also exist in, and hinder, other patient populations.Cardiac pacing today is an accepted and common treatment for patients with bradycardia, with almost 600,000 pacemakers being implanted worldwide annually [1]. In Pakistan, pacemaker distributors estimate approximately 1200 new devices being implanted each year (personal communication; Medtronic distributors for Pakistan). In addition to being a life saving procedure, pacemaker implantation helps improve patient quality of life. Cardiologists expect that most patients will be able to return to their pre-mor