Home Monitoring Function or Longer Battery Life

I had a Biotronik Edora 8 DR-T implated early this month and this PM model includes Home Monitoring function. 

In the post surgery check up session, my doctor informed me that she didn't turn on the Home Monitoring function for me because she understood that I concerned about the battery life. Turn on the home monitoring function will shortern the battery life for a year at least. Also, in Hong Kong (where I live), it's easy to go into clinic for PM check up. So, I agreed to not turn this function on at that moment.

However, I have a second thoguht about this due to the coronavirus situation (it never ends! We had it under control for nearly 3 months and now seems the infection number is going up once again) and my "worrying to much" personality.

So, I'm wondering... home monitoring function vs longer battery life, which one will you choose? Is Home Monitoring founction that useful and important?

 


8 Comments

Battery life -v- home monitoring

by LondonAndy - 2020-11-22 10:52:14

You do not say why you have had a pacemaker inserted, and there is no further information in your profile  That would be relevant for those more knowledgable than me to give you any advice. However, your doctor clearly did not think it sufficiently important to turn on, and indeed many pacemakers do not have this functionality anyway.  I have had a pacemaker for 6 years now, and normally only have an annual checkup.  Because of Covid, my clinic asked me if I would mind delaying the checkup that was due in October this year until March next year, and as I have not had any issues I agreed.  So this will make it 18 months between checkups, and I am 100% paced.

However, I do not underestimate the impact of anxiety, and of course a pacemaker is a new issue for you.  So perhaps worth asking if they will turn on the home monitoring for the first year, and then review?  So there would be some reduction in the battery life but not as much as a year if they turned off the monitoring then?

home monitors

by Tracey_E - 2020-11-22 11:30:33

Ask if there are different settings for the home monitor. Mine sends a download every 3 months, same frequency as I'd go in for check ups. It does not do daily reports like some do. I have had this battery since 2015, my leads are old, I pace every beat, and I still show 8-9 years left on this device, so excellent battery life. 

I would not be too concerned about battery life regardless. I'm on #5. Changes are super easy, and when we get a new one we get the latest technology. Don't needlessly waste battery, but don't fear replacements either. 

Home Monitoring

by Marybird - 2020-11-22 13:42:22

I guess I assumed that remote monitoring was a given these days when a pacemaker/ICD was implanted, and the monitoring schedule was pretty much standard at every 3 months, unless a patient needed more frequent monitoring or was not in a setting conducive to home monitoring. I know this was not discussed with me prior to the implant, I was just given the monitor with instructions and set up on a 3 month monitoring schedule, with a tachycardia alert ( which would send an alert when this occurred above a preset threshhold and was picked up by the monitor as I understand it). 

But my daughter had her pacemaker generator replaced in August, and they sent her home with a nightstand top remote transmitter ( hers is a Medtronic, mine is a St. Jude), and they told her she has a remote monitoring schedule of every 6 months. I guess the remote monitoring schedule does vary.

I have no idea how much effect the remote monitoring generally has on the life expectancy of the pacer battery, but I'd think perhaps if it were a significant source of battery life loss, they'd be a bit more conservative about using remote monitoring than they are. 

In my experience, the remote monitoring has been a godsend to me in this age of covid healthcare stuff. But ultimately, I guess it's between the patient and doctor. 

 

Depends on the natural history of your heart rhythm disorder

by crustyg - 2020-11-22 13:45:27

While there is no doubt that remote monitoring *does* take more out of the device battery than not having it, the difference isn't great.  BostonScientific state their expected battery life to include a routine remote interrogation with Latitude (under-the-bed gadget) which uses RF communication to talk to the device.  It's sufficiently power draining that when the PM reports that the battery is nearing end of life, this RF function is turned off to save the remaining battery charge.

BUT, the single biggest impact on battery life is the amount of energy required for each pacing output - this can nearly halve the predicted battery life.  In other words, leads that don't make good contact with your heart muscle and so require a high-voltage, long-duration PM output pulse to activate your heart will run your battery down much more quickly than the remote monitoring feature.

If the natural history of your heart condition is some further deterioration at an unpredictable time, then you'd want the remote monitoring.  If not, then you probably don't care, although the evidence is now quite good that a significant proportion of Covid-19 patients got the infection in hospital, and remote monitoring eliminates that risk.  Why attend hospital once a year or so when the technology is already available, inside you, to avoid that trip?

Remote monitoring

by AgentX86 - 2020-11-22 19:37:38

Reading the Biotronic page, it suggests that the transmitter is not alway active so sholdn't take much energey at all.  This particular model is smaller than most so has a smaller battery, so perhaps that's why the concern.

Hospitals here are considered one of the safest places to be, though doctors offices perhaps less so.  Hospitals have very strict protocols, use separate areas/air handling for covid positive patients and are limiting visitors, often banning them outright.  A neighbor just had a serious auto accident (one  car - evidently she passed out, so there may be relevence here).  Her husband was only allowed to see here for fifteen minutes a couple of times a day to minimize the number of people in the hospital at one time.

Doctor's offices, likewise have banned visitors/family unless the patient is cannot be left alone or move on their own.  Hospitals were a disaster six months ago but they've learned a lot since.

Monitor

by Persephone - 2020-11-22 22:47:38

Hi Amanda_Shanti... I've had a biotronik "cardio messanger smart" monitor at my bedside for about 3 yrs, to go along with my eluna 8 device. Things may be different with your device and situation, but I was never told by any medical professional or biotronik rep that there was any concern about battery life relative to the remote monitoring. I don't know my pacing stats off the top of my head, but I am paced the majority of the time.  My EP clinic tells me when to ensure the monitor is powered up and ready for quarterly (on a calendar year) interrogations, but I just leave it plugged in all the time. I don't take it when on travel 

Monitor

by AgentX86 - 2020-11-23 15:55:30

My normal monitoring is twice a year in-clinic and twice remote.  The remote has always been intiated by me so there isn't any need to keep it plugged in, though for some dumb reason I do.  I hate the thing.

Thank you everyone!

by amanda_shanti - 2020-11-24 08:12:47

Hi everyone, thanks so much for your experience sharing!

I had another discussion and PM checking yesterday. According to Biotronik's tech person, a device (a bit larger than a cell phone) will be provided for home monitoring function. All I need to do is to put it next to my bed, it will collect and transmits data every night (no option for transmitting frequency). An alert will be sent to my cardiologist if there are any unusual symptoms or problems. 

I also checked with my cardiologist, she said for my present health conditions (complete heart block, 100% pace, upper chambers' functioning well, issue with ventricle), home monitoring is not very necessary. But, since she knew I tend to worry a lot, so she suggested me to consider the HM foundation.

I'm still struggling about shorten the battery life for one year or to have a peace of mind LOL

LondonAndy — Thanks for your suggestion! Let me check with the tech person and see whether I can turn it on first, then review next year and turn it off if I feel more comfortable at that time.

Tracey_E — PM #5 !  Are the surgery, pain and recovery period the same as first implantation? I really afraid of surgery >.<

 

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