Medtronic ERI/Safe Mode changes - GOOD NEWS

In the event that you are not already aware, I thought I'd share this:

If you have been living with an older Medtronic pacemaker implanted over a few years ago (I do not know the exact date of model changes), chances are you will be subject to a mode change when you reach the elective replacement/safe mode (ERI) as the battery nears depletion. At that point your pacing rate changes to a constant 65 bpm and VVI mode (ventricle pacing only). Generally, it is not until that point that insurance (at least in the U.S) will allow coverage for a generator change-out.

When ERI happens, many of us begin to feel awful. I experience lack of energy and significant shortness of breath. I have often called that cruel and sadistic treatment only for the purpose of satisfying insurance companies. I have always claimed that Medtronic could develop a more humane means to accomplish that same thing. However, that is what we have had to live with. NOT ANYMORE!

In case you have not already heard; THE GOOD NEWS: All new Medtronic pacemakers will no longer use this mode change at elective replacement. Instead, to preserve battery life they will shed some other less consequential features such as arrhythmia tracking/recording at ERI. 

Having had many generator changes over the years I have always dreaded the time approaching ERI. I even have my current EP promise to get me in for replacement slightly ahead of it in an effort to avoid that period of suffering. So I see this as great news.  

7 Comments

It is great news!

by Tracey_E - 2023-09-21 08:46:13

I've always had Siemens/St Jude/Abbott and they are fully functional in ERI. My last one rate response turned off. I've never had one go to EOS/EOL with the set rate, thank goodness.

My current one is going to vibrate when it goes to ERI. 

Fingers crossed it all goes well and you get your new one before it cuts back!

metronic battery change

by new to pace.... - 2023-09-21 08:56:56

Thanks Good Dog for this important information.  I expect a battery  change not for 9 years now.  By then there might be more changes.

new to pace

Thank you for the valuable news

by Gemita - 2023-09-21 11:20:26

Thank you Dave.  I hope my current model, implanted in 2018 is unaffected, but I will ask next time I see my technician.

I certainly don’t tolerate ventricular pacing at all well, so am not looking forward to my battery wearing down.  I have still got around 3 years but that time will come round very quickly.  With this news I can be well prepared and hopefully make sure I get a replacement device before I start having symptoms.  

I hope newer Medtronic models won’t withdraw all helpful anti tachycardia pacing/arrhythmia features, so I would be interested in finding out exactly what features might be affected in newer models when my battery starts to fail.  Perhaps if you get further news, you could kindly update Medtronic members?   Thank you again and I hope all goes well for you

Just checked my manual

by Gemita - 2023-09-21 14:35:25

for both single lead and dual lead pacemaker models:

MEDTRONIC:

ENSURA DR MRI SURESCAN EN1DR01

ENSURA SR MRI SURESCAN EN1SR01

It states:  After ERI, all pacing parameters can be programmed, including mode and rate. Re-programming the pacing parameters may reduce the duration of the ERI to EOS period. 

However, you are quite correct, my manual clearly shows:

Parameter settings after/at ERI

Pacing Mode VVI
Lower Rate 65 bpm 

After ERI

by Good Dog - 2023-09-21 15:26:05

Gemita - Thanks for that info. It is good to know that they can re-program after hitting ERI. I was completely unaware of that possibilty. When I last hit ERI back in 2015 I was unable to contact my Doc so I went to the ER. They called Medtronic and advised me that there is nothing they could do for me. They emphasised the fact that I would be O.K. even if I did not feel well. That it was perfectly safe to temporarily pace only the ventricle. I said; "I know, but I am short-of-breath and feel awful". They just said; "go home and try to relax". So I don't know if my generator had that option or if they simply did not want to pursue it. Not an enviable place to be, which is why I asked my current doc to insure that he gets me in ahead of ERI.  

So I am thinking that since you cannot re-program before ERI it is some, but not much consolation. Obviously, the amount of time that you may have to suffer after the mode change will depend upon how quickly they are able and/or willing to get you in to make that program change. I would hope they could get you in the same or next day??? My luck; it would happen on a Friday night..............

 

Dave

It's about time!!!!!

by PacedNRunning - 2023-09-21 21:01:27

I wonder if all insurances think our mode doesn't change at ERI.  Boston Scientific does not lose any features at ERI. It still functions the same! For that, I'm grateful for Boston since I rely on this device 24/7 to pace every beat.  I was thinking someone needs to either make the insurance aware of this or the device companies need to change the function or when it hits ERI to allow for full pacing function.  Happy news!!!!  

 

Marybird- I see you corrected your terminology for EOL vs ERI for your daughters replacement. We had this discussion months ago where you stated she went into EOL not ERI.  This is what I was trying to explain.  ERI vs EOL are different modes. EOL/EOS is an urgent change for anyone relying on pacing or at risk if they receive no pacing. Now it's seems reasonable when you say she waited a week in ERI. ERI mode is ok to be in. Of course, with some devices it's awful.  I feel bad she had to suffer like that but glad it was only a week. Ive seen some wait longer.  

I agree with you explanation below

by PacedNRunning - 2023-09-22 21:52:47

Yes I agree with the mode your daughter was in (explained above) but it's important to know they are different modes in pacing. ERI and EOL/EOS are very different.  I do realize Medtronic dials down at ERI vs other brands do not. I also understand the reason for not making changes due to shortening the battery because they want to wait for insurance approval.  ERI does allow changes but EOL does not, it's a fixed mode.  I wasn't trying to argue with you in the original post.

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I've seen many posts about people being concerned about exercise after having a device so thought I would let you know that yesterday I raced my first marathon since having my pacemaker fitted in fall 2004.