Can a tech’s mistake damage my heart or pacemaker?

Hi all,

I have had a pacemaker for complete heart block (unknown cause; I'm 100% paced, but otherwise medically very healthy) since 2016.

Long story short:

On Monday, I went in for an MRI for something completely unrelated to my heart. I have an MRI compatible pacemaker that simply needs to be set by a tech before and after the MRI, and I have had at least 2 MRIs previously with this pacemaker without incident.

The techs who adjusted my pacemaker on Monday were new (they literally greeted me with "we're new here" when they walked in) and one seemed to be training the other. While interrogating my pacemaker, one of the techs (I found this out later) somehow turned my pacemaker up to 6 volts when it should have been maybe 2 or less. This caused my left side visibly to twitch visibly while my pacemaker felt like it was trying to jump out of my chest. This went on for maybe 10 min while they waited for a more experienced tech to come down and fix what they'd done and reset my pacer.

My question for you all:

Could their mistake have damaged me or my pacer?

The experience while it was happening felt pretty awful (and the tech's incompetence was pretty scary), but I initially wasn't worried that there would be any lasting effects. Over the past couple of days, I've started wondering if I should be worried. I'm not experiencing any symptoms, just nervous.

Has anyone else had this kind of mistake happen to them during an interrogation? Anything to worry about?

Thanks all in advance for sharing your thoughts and hopefully just giving me some peace of mind. Thanks!


I don't think so

by crustyg - 2022-09-16 17:22:26

In theory the worst that would have happened is a very slight reduction in PM battery life, but for 10min or so I think you'd be hard put to prove it.

Not a pleasant experience, and I think you're correct.  It shouldn't have been the blind leading the blind, but an experienced EP-tech training a novice.

I think the real areas of possible damage are things like over-pacing you for a significant time (month or so) => can lead to high BP, or leaving your settings so that you get PM-mediated tachycardia (you need to have significant retrograde conduction for this) => Tachy-induced cardiomyopathy.   It's still debated, but IMHO, prolonged RV-apical pacing carries a significant risk of LV-remodelling => reduced %LVEF which may respond to CRT, but may not, but that's an EP-doc issue, not an EP-tech issue.

More serious is when EP-techs *miss* something important in the PM's settings, but it's debatable whether that causes harm or just makes life miserable until corrected.

Others may have their own ideas on this topic.

I doubt it

by AgentX86 - 2022-09-17 00:25:11

I don't think it would permanently hurt either you or you pacemaker.  I can understand why it was unpleasant but I don't see how it could do any real damage.

What I don't understand is how this could happen.  They're supposed to download the current settings and restore those settings exactly as they were before.  All of the settings are transferred at one time.  There shouldn't be any "editing" of the settings at all.

This beggars belief and I would probably have considered walking out

by Gemita - 2022-09-17 05:16:58

Kcambridge, my main concern would be that if a technician was not capable of placing a device in a safe mode without triggering additional problems, could he/she really be trusted to have carried out all the necessary checks for safe scanning for the duration of your MRI?

In the very least I think for the safety of other patients you should consider reporting this and making sure that the two individuals involved are questioned about this incident.  I also feel that no long term damage has been caused, but it could have been so very very different.  Totally unprofessional in my opinion.  Pre MRI safety checks need 'skilled' cardiac technicians present.  Certainly not the time for trainees

if they disable it

by dwelch - 2022-09-20 07:42:48

certainly if they disable the device and you then have an event where you need it then obviously that can hurt you.   

the device itself likely cannot be damaged it should be tested to an excess of what the settings are.  these are medical devices and go through a very long process of examination and such.  

I so far have avoided an MRI and still not sure I can have one.   If the mri techs mess with your device before and after, yeah, avoid the mri or go to a facility where a pacer tech is responsible or better yet someone from your EPs office.

This sounds crazy what happened, unacceptable, might even want to talk to a lawyer, if for no other reason than protecting the general public from this facility, by giving them a wake up call.

You know you're wired when...

Your favorite poem is “Ode to a Cardiac Node”.

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