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Intraoperative pacemaker malfunction during total hip arthroplasty.

A report from 1983 states that there are more than one million pacemakers in North America and over 500,000 in the U.S. alone (1,2). In addition, more than 120,000 pacemakers are implanted each year. Because this group of patients is subject to the same diseases as the general population, it is likely that some will require one or more surgical procedures after receiving their pacemakers. Pacemakers, especially demand pacemakers, have an extensive and diverse history of intraoperative complications, including temporary inhibition, reprogramming to asynchronous mode, falsely revealing an end-of-life pattern, precipitating ventricular fibrillation, and even complete pulse generator failure (3-10). We report the rare occurrence of complete irreversible pulse generator failure in a patient undergoing total hip arthroplasty.