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April 2015

Unnecessary Pacemaker: Care Coordination Problems and Language Barriers

Author Affiliations
  • 1Montefiore Medical Center, Bronx, New York, New York
JAMA Intern Med. 2015;175(4):487. doi:10.1001/jamainternmed.2014.7690

We met an elderly patient who had a history of hypertension and diabetes. He was admitted with complaints of dizziness and a “feeling of slow heart beat” for the past 2 weeks. He also had 1 episode of a presyncopal event and an electrocardiogram indicating third-degree atrioventricular block. This seemed like a straightforward admission. By the time we first met the patient, cardiology had already decided to place a pacemaker. During rounds, we asked what could be the cause of this patient’s bradyarrthymia. We sat down with the patient and talked to him to gather more pieces of the puzzle.