Yes. For several reasons depending on the underlying condition. First, there is the underlying reason for the pacemaker. If the heart is too slow and not beating, the drugs increase the risk of abnormal beating some which could be fatal. But, if the pacemaker is put in because the heart is beating irregularly and FAST, the drugs are GUARANTEED to trigger that and have disasterous effects. Lastly if it is a defibrillating pacemaker put in for near fatal abnormal beating, the drugs can trigger this and make the hear resistant to being fixed by the defibrillator. One patient I had with this condition died at age 30 from cocaine and just got many many painful jolts from the defibrillator while dying from the cocaine .
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