Complications of Permanent Cardiac Pacemakers

To the Editor: In their article in the May 30 issue, Phibbs and Marriott1 have once again raised issues that they have argued previously and have been answered elsewhere.2 3 4 The question of the magnitude of unnecessary pacemaker implantations was raised. We are asked to accept the unreferenced, unreviewed figure of 75 per cent. When this type of reporting was subjected to unbiased review in the state of Maryland, the figure dropped from 23 to 1.4 per cent.5 Major Symptoms cannot always be correlated with bradyarrhythmia. Many patients having a pacemaker implanted for syncope relate symptoms of fatigue for many years.