“…Important, corticosteroid use can result in skin anergy and in a false-negative skin test. Allergies to various pacemaker components have been reported, including titanium (Peters et al, 1984;Yamauchi et al, 2000), polychloroparaxylene (Iguchi et al, 1997), nickel (Landwehr & van Ketel, 1983), polyurethane (Abdallah et al, 1994), epoxy (Andersen, 1979), mercury (Brun & Hunziker, 1980), cadmium (Laugier et al, 1975), chromate (Laugier et al, 1975), silicone (Raque & Goldschmidt, 1970), and cobalt (Tilsey & Rotstein, 1980). Once an allergy has been demonstrated, it is imperative that the component either be eliminated from subsequent pacing systems or be completely coated.…”