Beware Low Battery combined with Bad Lead

My Medtronic Revo pacemaker's battery finally got low enough to reach Recommended Replacement Time (RRT), and switch into its energy-conserving end of life mode. This end of life mode includes switching from dual-chamber pacing to just ventricular pacing.

Meanwhile, we knew for several years that my ventricular lead was bad. That wasn't an issue because my pacemaker didn't need to use it since I was (and am) almost 100% atrially paced.

But you can see the problem. When my pacemaker switched to ventricular pacing, it needed to use my ventricular lead, which didn't work. So I wasn't being paced, and my unpaced heart rate was very low.

I'll leave out the drama and just say that my doctor's organization got a new pacemaker into me pretty quickly.

It seems to me that my doctor's team should have anticipated this problem, and should have replaced my pacemaker before it reached Recommended Replacement Time.

The point of this post is that if you find yourself in this situation, you can bring it to the attention of your doctor. I was too clueless to see it coming.

-Mark

5 Comments

Woah!

by MinimeJer05 - 2022-08-09 17:49:34

Mark,

Thanks for sharing! It sounds like a very scary and frustrating situation, but what's important is that you got your replacement. Did they extract or replace the lead? 

Hope you are feeling well.

Take care

Jer

Helpful Post

by Good Dog - 2022-08-09 20:52:49

Thank you for posting about the problem you experienced. Not something I would have thought about. My Medtronic PM unexpectedly went into EOL mode prior to my last generator change. Caught me by surprise. Based on my last interrogation, If I recall, I should have had about 4 months remaining. I gotta tell you that even with my good RV lead, I felt terrible with my heart so out of sync. My Doc's PM Tech acted like hey, no big deal. I wanted to punch her. Anyway, you may well have helped-out somebody with a similar problem.

Thanks,

Dave

Seems strange

by AgentX86 - 2022-08-09 21:56:16

Is RRT the equivalent of EOL (End Of Life) or ERI (Elective Replacement Indicator)? I assum RRT = EOL because that's where it starts shutting down features.  There is only about three months between them.

Many insurance companies won't pay until EOL but the your failed lead should have been taken into account. Your doctors should have anticipated the problem and taken care of it  before.  I'd be one pissed cat!

My Medtronic pacemaker has been recalled.  The pacemaker is to be replaced at ERI and those who are dependent, ERI is to be treated as an emergency. I'd think a failed RV lead would be treated the same.

Do you have a monitor?  That's one of the advantages of the Medtronic app.  It'll report ERI/EOL automatically.

RRT and EOL are different

by PacedNRunning - 2022-08-11 04:41:08

RRT OR ERI is a notification 3 mos until EOL. After  EOL, 3 mos remaining. 
 

oh wow! I'm sorry that happened. Thanks for letting people know! That's super important to know. Glad your ok! 

They didn't replace the bad lead

by AbNormative - 2022-08-12 16:53:17

By the way, they didn't replace my bad ventricular lead.

After my situation came to light, they scrambled to pull together the people and the room over the course of one day, and squeezed in the surgery at the very end of the day. So there probably wasn't time to do anything regarding my ventricular lead at the actual surgery.

Earlier in the day, one of the doctors had pretty much eliminated the possibility that the ventricular lead's problem was at the pacemaker end. He had me move my arm and pacemaker around in different ways while watching the Medtronics programming console for any effect (but there was none). So it looks like the problem is at the heart end of the lead.

-Mark

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