due for battery replacement

I am due for a battery replacement soon, I think.  My PM was implanted in February 2011 (St Jude).  Last June 2020, I had 4 years left.  My last PM check (March 26th) shows I have 2 years left.  Two years disappeared in 9 months.  My pacemaker nurse said I should keep an eye on how fatigued I get.  Just curious what you experience when your battery is running low.  I get dizzy too.  My legs get heavy but I can walk a mile still.  


5 Comments

replacement time

by Tracey_E - 2021-03-29 20:47:11

As you've learned, those numbers are just estimates. When it gets down to <6 months, they generally increase how often they check it. The closer it gets to the end, the more accurate the estimate, but it's not like a gas tank in a car that tells us how many miles are left. 

Is the dizziness and heavy legs new? If yes, give them a call.

A quick test, when you take a walk, is your rate going up or staying at a steady 60 bpm? If it's not going over 60, for sure give them a call. That means it's switched modes. 

The pacer is not going to just stop. First thing it does is give them a heads up it's nearing the end, that's called elective replacement mode and it lasts approx 3 months. At this point, it's still fully functional. At the end of that stage, it goes into end of service mode. How it feels at this point will depend a lot on why you have the pacer and how much you use it.  It will still keep us perfectly safe in the stage, but it cuts off some of the extra functions so if we pace a lot, we won't feel good at this point. I'm on my 5th and have not yet gone into this mode, we've always scheduled the replacement when it was ERI. When I get close to ERI, they had me come in once a month, then when it went ERI, we scheduled replacement.

Replacements are a piece of cake! They go in the same place so it's mostly scar tissue. If your leads are good, they will leave them alone. If I get an early appointment, I'm home fixing my own lunch.

We also get a technology upgrade. You will likely get a home monitor this time so going to the office is a once a year thing, the rest of the time the downloads happen automatically. I have SJM (now Abbott) also, my checks happen every 3 months.  I get an email from my ep's office a few days later letting me know all is ok. If there's ever a question that something might be going on, I can hit a button to initiate a report, then I just shoot them an email so they know to look for it. Saves SO much time! 

battery replacement

by Moana - 2021-03-30 12:57:19

Thank you Tracey for your thoughtful and most helpful response.  I ended up with vertigo last night and still dizzy this morning but a little better.  I do have bouts of vertigo which are more frequent this month.  I attributed it to my covid vaccine reaction.  I am very excited about the technology update you mentioned. 

 

Battery Replacement

by Marybird - 2021-03-30 16:09:15

Hi Moana,

I think Tracey about said it all.

I just wanted to share my daughter's experience with her pacemaker that did go into the "End of Service" mode before she had the generator replaced last summer.

She got her original pacemaker in Jan 2012- a Medtronic dual chamber, that lasted well over 8 yrs despite her pacing 100% atrial. They knew around Jan 2020 it was about time for a replacement, figured they would replace it when the pacemaker reached the ERI- when it was still pacing normally, according to the settings. But then, covid related delays, postponements, etc intervened, and she reached the End of Service mode before it was replaced. She had been informed by the nurse that the ERI mode would be heralded by an audible alarm, and would last for 3 months from the first alarm till the EOS. She never heard an alarm- that's because there were no such functions on pacemakers of this vintage ( 2012).

She woke up one morning, felt listless, and just lousy, discovered her pacemaker was pacing at a steady 65 BPM no matter what she did. She contacted the office, got in for a pacer interrogation which verified the pacemaker's EOS status ( including the exact date and time it went into EOS) and they scheduled the generator replacement for a week later. They told her to take it easy, told her to expect to feel dragged out, and she took that week before the surgery off from work ( she's a nurse).

It was easy peasy for her too. The settings on her old pacemaker had pretty much been optimized over the years for her ( lots of trial and error) so they used those same settings on her new pacemaker. She went home that same afternoon, went back to work two days later, and says the new pacemaker makes her feel better than the old one did. She's got a remote wireless monitor and is apparently on an every 6 month schedule for monitoring.

battery replacement

by Moana - 2021-03-30 22:50:33

So glad to hear from you., Marybird.  I am being crazy worried because I exceeded my 10 years last February 17, 2021.  I got into 2 car accidents rear-ended really hard and the airbags deployed into my chest.  Could have broken the leads but I was ok on both times, according to the doctors who attended to me.  I hope I get a wireless monitor as well.  Mine is vintage as well have been installed in 2011.  Best wishes to your daughter. 

Just Another Thought

by Marybird - 2021-03-31 18:13:04

Wow, after 12 years I can imagine you would be waiting for that shoe to drop, so to speak, figuring that your pacemaker needing replacement has to be just around the corner.

You probably know this already, but as I understand it the pacemaker techs/ docs keep an eye on the remaining pacemaker voltage ( more than on the estimates of time left) to determine the approximate time till it needs to be replaced. I know that is what they did with my daughter over the last year and a half or so before her pacemaker was replaced. They had originally believed she would need the generator replaced around January 2020, but based on the measured voltage during an in-office device interrogation in January they determined this could wait till at least June or July 2020. At that time she was informed ( erroneously, as it turned out), that the pacer would give off an audible signal when it reached the ERI stage. They also instructed her to send them remote pacer check reports every 3 months so they could keep an eye on the voltage. 

Well, she went home and promptly disregarded their instructions. And she figured all was well because she had heard no pacemaker alerts. Fast forward a few months ( around June or so), she attempted a remote pacing session with her Medtronik Patient monitor ( not automatic, patient must initiate those) and discovered the monitor was non-functional. Long story short, between poor Medtronic customer service ( in my opinion), covid related office visit cancellations and postponements, she didn't have her pacemaker voltage checked at all till it reached the EOS, and they replaced the pacemaker soon after that.

The cautionary tale from her experience would be related to anyone wanting to have a pacer replacement cause as little disruption in his/her life as possible. You know you have pretty much fair warning when your pacemaker is close to its end of service, but once it gets to that point, that automatic pacing at 65 BPM no matter your activity can leave you pretty much down and out depending on your dependence on the device. That's disruptive any way you look at it.

So in your shoes I'd suggest you arrange with your doctor's office/ device clinic/ pacing techs remote monitoring at intervals they suggest to keep an eye on your pacemaker voltage. This information gives them a pretty good idea of just how much time is left, when your pacemaker reaches its ERI, and hopefully you can get it replaced before you get to its EOS. 

I'm sure you will get a wireless remote monitor with a replacement pacemaker generator that will communicate with that monitor via bluetooth technology, that's the state of the art these days. If you have a St. Jude pacemaker now, it's likely to be replaced with another St. Jude pacemaker, and that will come with a Merlin@Home wireless monitor. That's what I have, and have had no problems with it. 

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I am 100% pacemaker dependant and have been all my life. I try not to think about how a little metal box keeps me alive - it would drive me crazy. So I lead a very active life.