Psychosocial Factors in the Adjustment of Patients with Permanently Implanted Cardiac Pacemakers

Sixty patients were studied for adjustments with and to permanent pacemakers implanted 6 years to 1 month. Their median age was 72 years. Most patients make an excellent psychological adjustment to cardiac pacemakers with a rejuvenating lease on life; only a small minority exhibit anxiety about the pacemaker. The patient's individual adjustment appears to be a function of his physical status, duration of symptoms, his available object relations, his adjustments to previous prosthetic devices, his personality style, and the adequacy of pacemaker function. Age, sex, and socioeconomic status do not appear to be important factors in patient adjustment. Psychological illness per se is not compounded by the use of pacemakers. In this older age group the pacemaker and the associated physician seem to provide a more concrete basis on which to depend than the nebulous fate of old age.