[Psychosomatic aspects of pacemaker therapy].

Modern pacemaker therapy offers a highly differentiated treatment of symptomatic bradycardia, hardly susceptible to failure, combined with low operative intervention and risk. Only little attention has been paid to psychosocial aspects during the past; this explains the sketchy knowledge of this field. Prior to implantation there is, at first, a high rate of depression, which decreases after the operation. A number of favourable and unfavourable factors are described, concerning the acute and the long-term adaptation to the unit. Emotional and cognitive functions usually improve significantly during the follow-up period compared to the pre-operative state. This fact as well as social rehabilitation, which can only be realized partially, lead to an acceptable quality of life; therefore, for the majority of pacemaker patients, no essential modification of the usual control examinations seems to be necessary. But a small group of risk patients need the enhanced attention of their cardiologists and eventually interdisciplinary assistance.