Battery Replacement

Hello,

I had a Medtronic pacemaker implanted in 2006 at 23 years old to treat syncope. I went for my semiannual check-up in September where they told me I had approximately 12 months left on the battery. At my check-up this morning, they informed me that my battery actually ran out only a few weeks after my visit in September and it went into conservation mode. They are regarding this five months of "no episodes" as an indication that my condition has gone away and pacing is no longer need. But they want to leave the battery and leads in place since I have a sub-pectoral implant. I'm confused about a number of things.

a) How could the remaining battery life be over-estimated by 12 months? Aside from the first year, my usage pattern has been consistent for a long time.
b) Can you really leave a dead pacemaker in the body without any side effects? If I don't need this, I would rather not this hunk of metal in my chest.
c) Is my condition completely cured? Before getting the pacemaker I went into cardiac arrest nine times in one year and had 254 rate drops last year alone. I'm nervous to wave the victory flag quite yet.

If anyone has had any similar experiences I would love to hear. I'm just generally confused by this news and unsure how to proceed.

Thanks,
Emily

5 Comments

I agree with your concern

by BillMFl - 2014-02-26 10:02:00

It seems unlikely that your risk of an arrest would have suddenly just gone away. None of us prefer to have a foreign object in our body, but given the serious events you have had, I would be conservative and have a replacement. An uncomfortable rythm or some brady is one thing but arrests are way more serious. Trust your own judgement.

asfasf

by boxxed - 2014-02-26 10:02:42

Okay, there's a bit to break down here.

As far as A. Some pacemakers can be unreliable when it comes to its estimate when it's getting close and suddenly you go from 13 month remaining to ERI. It definitely happens. Does not happen often, but how often it happens doesn't matter much when you're the one that got burned by an unreliable battery estimate.

I can't comment on B too much

As far as C, and I think this is pretty important, please call your office and make sure that the PM did NOT stop collecting data when it reached ERI in October. A handful of PM models STOP EPISODE DATA COLLECTION the moment ERI is reached. The fact that it didn't report many episodes may simply be because it stopped recording a few weeks after your previous check.

guesses

by Tracey_E - 2014-02-27 07:02:16

Battery life is a range, so even if they said 12 months, the report would have said 9-18 months, or something like that. They don't run out like a tank of gas, where the needle steadily goes down. It goes full force, full force, full force, then plummets. There are some warnings that it's going to plummet but they're not always accurate, as you learned. It happens.

As boxxed said, it cuts back what it records after it goes EOL. Also, it does not stop pacing!!!! It still paces, it just doesn't pace with all the bells and whistles. Instead, it only kicks in if our rate goes too low, and it paces at a steady rate of usually 60. For someone like me who paces every beat, I'd feel the change instantly. For someone like you who just kicks in with a few paces here and there, you likely wouldn't feel the difference because it's doing what you need- making sure your rate doesn't plummet.

I would not even consider not getting it replaced. It's ok to hope for a miracle, but don't trust it with your life. Replacements are easy. If you get it replaced and the nice new one that records all the episodes goes a few years and says still says you aren't pacing, then you can trust in it and talk about removing it.

Yes, they can be left in. Sometimes taking it out is riskier than leaving it in because any surgery has an inherent infection risk. If you were to eventually have it removed, you'd probably want to remove the box but leave the leads. They're a lot more complicated to get out and a higher risk procedure.

Life Without Pacemaker

by donb - 2014-02-27 10:02:40

Hi Emily, Tracey gives a good message !! As I have had similar experience in the past 22 years of replacements with 6 pacemakers. I have been without a pacemaker for a maximum of 60 days because of removal because of erosion. I've had this twice over the years & each time tests showed I no longer needed a replacement. Both times I gradually reverted back to my Bradycardia. I did not get into syncope but felt unwell because of HR dropping into low 30's.
It would really be great in your case to not need another pacemaker, but, risk is a nasty word which none of us enjoy. As I've also had my 4th replacement "under muscle" right chest followed with 5th replacement also. I now have my 6th replacement in abdomen (belly) also under muscle & it's been the greatest for comfort. So, Emily, any questions, keep us posted as we're all very concerned with you getting the best of care.
DonB

Some Tough Love for a Grandchild...

by donr - 2014-02-27 11:02:17

...Emily, you are not mine, but the same age as some of them. I sat down w/ one of them last June & counseled our youngest granddaughter before she made a life changing decision. Sometimes you have to talk harsh facts of life - that's what Grandfathers are for. We have usually made a few more trips around the Sun than our children & our Grandchildren's siblings.

Here goes:

Predicting anything - other than whether or not the Sun will come up somewhere tomorrow is impossible. If we could predict the future well, we'd all be millionaires from profits buying & selling stocks & bonds! The same applies to predicting battery life. Matters not whether you are predicting battery life for PM's . Fords or Jaguars! It's impossible to do reliably.

I likewise have a Medtronic PM. Mine predicted it would go into ERI on a Monday. Missed by three days - went into it the Saturday prior at 1220 PM. Now my Cardio warned me that when it went into ERI, it would STOP everything EXCEPT pacing me. Everything meant NO:
Data collection
Sensing
Inhibition
Testing
Etc.

It went into a FIXED pacing mode of 65 BPM, where it would stay till it finally died & the PM quit. I realized what had happened on Mon at about 3 PM when my wife checked my pulse & got 66 BPM. Normally I run in the 80's, so we took the clue & went to the Cardio's office, where it was confirmed. Gave me an Appt for Thurs to get it replaced.
Today must be battery day in the PMC - this is the third post on it.

I will argue w/ Boxxed about his choice of words - "Unreliable" is wrong word. "Imprecise" is the better word. Remember that your device is trying to predict the future - not possible w/ any precision.

I will NOT denigrate your question - it is a good one & deserves a decent answer. To summarize all I said above - it is impossible to precisely predict the future, even for things that appear to be running at a apparently predicable, consistent rate. Generally speaking PM's do a pretty decent job of it. You have no access to the experience of the millions of others who have PM's, so you cannot judge by the performance of yours. It's a sample of ONE out of the millions out there.

Before I get to question b), let me address Question c): Remember that I said it quits recording data when it goes into ERI? This is an example of NO NEWS NOT being good news. It is merely NO NEWS. You have NO idea what your heart did once the PM stopped recording.

There is a strong desire among all that their heart repair itself & you return to the carefree life of your youth. Indestructible & you will live forever and a day. Perhaps so, but that will take a miracle. That just does NOT happen in the usual case. Ever have a TV set croak? Did it ever come back to life or did you replace it or fix it? Same is true for the electrical system of your heart. I know of no simpler way to put this - Accept that your heart has failed you. It will NOT fix itself. You will most likely ALWAYS have that "Chunk of metal " inside you. Be thankful you did not live 50 yrs ago - that chunk of metal did not exist to keep you going comfortably.

Let me ask you several questions here:

1) If you needed a new hip joint, would you accept an artificial hip joint?

2) If you needed a new artificial knee joint, would you accept that?

3) If you lost a leg below the knee to an auto accident, would you accept a prosthesis?

4) If your spine developed scoliosis & they needed to place several Titanium bars along side it to straighten it out so you could even get out of bed, would you accept them?

If you answer "Yes" to any of these questions, I will ask you what the difference between them & the PM?

If you really want to bet that your heart problem is cured, just don't bet your life on it. It is a very low probability outcome. Based on your heart's previous track record, it is NOT cured. It only takes ONE cardiac Arrest to kill you & you had 9 of them. You are betting on a lame horse.


Your question b):

Yes you can leave the dead PM inside of your body. Why not - it's Titanium, does not rust, corrode, etc. Considering that you have a sub-pec install, it is a non-trivial procedure to pull it out. It should not react to/with your body whether it is functioning or not.

Your final question- how to proceed.

Get the PM replaced ASAP. It's that simple.

Donr (Surrogate Grandfather)

You know you're wired when...

You forecast electrical storms better than the weather network.

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Hi, I am 47 and have had a pacemaker for 7 months and I’m doing great with it.