Suicide attempt by pacemaker system abuse: a case report with comments on the psychological adaptation of pacemaker patients.

Thirty patients selected at random from a pacemaker clinic were interviewed to gain an understanding of how psychological symptoms in these patients related to their cardiac condition. In 20% veiled depression or even a wish to die was elicited. Joking, fantasies, and denial were common psychological mechanisms used to adapt to their illness and the pacemaker itself. A dramatic example of attempted suicide in which the patient tried to cut the subcutaneously implanted pacemaker leads is presented and illustrated.