Need replacement

At my cardio office yesterday, seems I have one month left on power supply life of my initial Biotronik pm. PM rep told me in about a month unit will decrease power and reduce preset rate of 60 bpm down to about 54 bpm (an 11% reduction) this will probably extend power supply life by about 3 months.
Have any of you gone thru this?
Because I am now over 65 years old, I am on medicare. My cardiologist says because I am not totally dependent on PM that I must be in a life threating situation for medicare to cover me. Have any of you experienced that situation?
Thanks in advance for any feedback you can provide.

7 Comments

A resounding NO!

by donr - 2013-09-24 08:09:13

I have heard nothing along those lines & I'm 77.

I'll ask our cardio's head nurse tonight & hopefully she will have an answer.

Don

Getting A New PM

by SMITTY - 2013-09-24 08:09:43


Hello.

You have a different make of PM from mine (which is a Medtronic) so that may explain the difference in what I have to say and what your dr. has told you. As I have said what I have posted below is what I have told several others about a PM replacement, which is based on my experience. If it helps you good, or if you think it best if not read, I have no problem with that either.

But, below is something I wrote for a member that was going through pretty much the same thing you are. I'm guessing you are thinking about what may happen if your PM battery runs completely down in between your visits to the dr. The likelihood of the PM stopping without warning is about the same as it is for the sun to set in the East. It just ain't going to happen.

When the battery power reaches a certain level known as EOL (End of Life) or the PM goes into ERM (Elective Replacement Mode) or one called a VVI there is enough battery power left to safely operate the PM for at least three months.

You will know when this level of battery power is reached as the PM shifts from being an on demand PM to a full time PM. As a full time PM it will make your heart beat at a constant 65 BPM, regardless of the settings it may have. When this happened to mine I knew it without a doubt. The low setting on mine was 80 and one morning I got up with a constant heart rate of 65 with a some irregular beats thrown in for good measure. It got my attention immediately.

Fortunately for me I had read what would happens when the battery reaches EOL, ERM or VVI. While it was not painful, it was uncomfortable enough to cause me to call the dr. office ASAP. I was told to it was probably a low battery and to come in for a checkup. The low battery was confirmed and I was scheduled for a new PM the next day.

The thing is, don't be concerned about being left without a working PM because of the battery. Our PMs have enough safety features we will not be left out in the cold without any warning the battery on the PM is reaching the end of its life.

Good luck,

Smitty

Medicare pays

by Pollypacer - 2013-09-24 09:09:40

I am 75 years old and have had my PM for a year and a half. Medicare and my Medicare Advantage Ins. paid for my PM, I only had some minor bills to pay, but they did pay for the pacemaker.

Negative

by PacerRep - 2013-09-25 10:09:05

Once you have a PM, the battery change is absolutely covered once it goes down. You've already been indicated for a device. Get a different cardiologist.

She finally called me...

by donr - 2013-09-26 09:09:26

...my cardio's nurse, that is.

Here's what she said: Right now they are still being reasonable about new implants & replacements. There are some areas of medical care in the cardio field that are being treated pretty strictly - like stress tests. echo's,

The word they are getting is that come the implementation of Obamacare, Medicare will become tacky about replacing PM's - requiring that people wait till they definitely are in ERI at least. This will cramp the style of those that are PM dependent. Right now they prefer to replace those PM's sooner than ERI. Nothing as draconian as what you were told.

The world is rife w/ rumors. We really have to just wait & see what is going to happen.

Don

Thanx

by dz0pzw - 2013-09-26 10:09:17

Don, & Others,
Thank you for the feedback. I have been with my cardiologist for 35 years this November, so as I'm sure you can Imagine I don't want to start over with someone new. Think I am in the situation you describe Don. Apparently I have about a month left on current device before it drops into end of life mode. That would still give me time to get a replacement before the affordable care act takes effect. I just really didn't expect them to take it all the way out to the end of the device's useful life. Thanks again to all those who offered advice.
Warm Regards,
dz0pzw

It's NOT a pretty picture...

by donr - 2013-09-27 09:09:39

...mainly because of the uncertainty involved.

Since it is not life threatening, since you are NOT dependent, Going into that EOL state is just a miserable experience, not a death notice. I had it happen to me - except I have a Medtronic & it dropped into its default mode of pacing me at 65 BPM, whereas it's set for a 75 minimum. I felt like unmitigated crap! Started on a Sat at 12:22 PM & they had me in the OR on Thurs at 1 PM. Reason it took so long was that I did not realize what had happened till about 4 PM on Monday.

According to my nurse friend, the real problem is for the PM dependent hosts. IT's not so much that Medicare (or whatever we will call it under Obamacare) will not replace dying PM's, but the requirement that the hosts wait till they at least hit those final phases of battery life - either EOL phase, or the phase that precedes it, ERI (or whatever they choose to call it for the elective replacement period).

I think one of the problems the Cardios face is how long they will take to get Medicare approval PRE-OP for the procedure. Right now it is effectively a rubber stamp effort, but may well turn into a major bureaucratic non-medical approval goat rope that takes time while the host suffers needlessly.

In my case, I wandered into my cardio's office, his nurse hooked me up to the downloader, said "Oh, My God," & reached for the phone. She called the practice's EP & they scheduled me for the replacement in a non-emergency situation on Thurs. I saw zero attempt to get any pre-approval from Medicare. That may all change.

Don

You know you're wired when...

You have a dymo-powered bike.

Member Quotes

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.