Replacement device - still no home monitor

I have third degree heart block from a surgical complication when my aortic valve was replaced in 2014, and so before I left the hospital a pacemaker was implanted. I didn't have any arrhythmia or other electrical issues before the valve surgery, and frankly I have never really noticed any difference now that I am paced.

Anyway, here we are 8 years later and the original Medtronic device needed replacement owing to getting low on battery. After a number of final tests on the day of surgery, the decision was that a simple "box change" was needed - no changes to functionality needed, and sure enough I was on my way home with the new device later the same day. Amazing what they can do, all under local anaesthetic not feeling anything, no need for painkillers even once I was home.

I thought I would mention that once again I have not been given a home monitor, though since I have never had a pacing issue that doesn't bother me. I will continue to go for annual check-ups only. But one thing I noticed was that to interrogate the device I was no longer connected to a machine via a heavy "puck" type magnet resting over the area of my device - a small, hand-held machine was held close to me and connected via Bluetooth, and all readings and tests were done wirelessly. Presumably this will make it easier for any ER type visit in the future to check it over.

Finally, this device is expected to last over 12 years of 100%, compared to the previous pacemaker's 8 years of service. 

4 Comments

Thanks!

by Lavender - 2022-11-28 21:43:04

Good to know that your replacement went smoothly! For the past year, they haven't used that old heavier wand on me that lays on the device. They just wave a small mouse over me and it connects. 
Hoping that battery life is extended with new devices. I do have a home monitoring device but it's never been needed. 
I know you were concerned that a third lead would be placed, but it sounds like you didn't need that and still have two leads. 

You are doing well

by Gemita - 2022-11-29 03:49:40

Hi Andy, thank you for the update.  Perhaps in your case "no monitor" means absolutely no need and it sounds to me as though you had some impressive test results at your last pacing check?  I am so glad your pacemaker has fixed your block and that you are not having any other electrical disturbances/arrhythmias.  You are indeed fortunate and this makes pacing so much easier to manage.

As a matter of fact we will soon be heading off to Kings College Hospital for my husband to have some additional checks because of near syncope/collapse last week.  They want to see whether any events have occurred and to check his pacemaker is functioning normally.  Because this continues to happen they have agreed to give us a home monitor.  I have been asking about this for some time, so that is progress indeed.  I already have home monitoring (under St. Thomas' Hospital).  It seems Kings College Hospital still don't routinely give out home monitors (only mainly to ICD patients), but from my telephone conversation with the technician at Kings this policy might be changing.

You mention pacing continues to go well for you so I presume all your old settings have been transferred to the new device.  Do you feel any different as though you are more energised from the new battery?  Did you get another Medtronic (hope you have put the new model in your Bio?) and were you told of any new additional special features the new device offers apart of course longer battery life?  And final question!  As the battery lasts longer, is the device itself larger since  I see that you had absolutely no problems with post op pain, so I presume it fitted neatly into the old pocket?

To Lavender and Gemita

by LondonAndy - 2022-11-29 08:20:33

Thanks for your comments, and Lavender you are right: I was concerned about the need for a third lead (though would happily have gone along with it if that is what they recommended), and that was the reason for one of the extra tests on the day: they did a fresh ultrasound scan with some dye injected into me for better clarity of the heart muscle function, and they were happy with what they saw.

Gemita: I hope Kings are able to improve things for your husband. (My op was at Barts, where they did 8 pacemakers that day - apparently that was a quiet day!

It is indeed a larger device - I heard the surgeon say so as he was trying to push it into the existing pocket, and he took ages doing the sutures, though did an amazingly neat job. Even the anaesthetist commented how long it took, as he was one of the two people who wheeled my trolley back to the ward! I can feel it is a bit bigger, but not to the extent it is obvious.

Finally, yes, all the same settings, but no "extra energy", sadly! The battery had not reached End of Life mode or anything, so to be honest I wasn't expecting to feel any different.

ask the doc

by dwelch - 2022-12-29 13:30:20

I really do not want my monitor, I have had pacers for 35 years.  Has the quality gotten so bad that they need to be monitored daily for legal protection?

Just ask.  After monitors had become a thing I got a device that was not supported by the current monitor for that brand, it was on the next device and they asked me about it told me the procedure you will get it in the mail, a number to call to set it up, etc.  I waited until the pandemic and got the monitor to avoid going into the hospital for my checkup.

Another feature of the monitor is that it generates revenue for everyone involved, we are back to the model of a third party collecting the data then charging the doc/insurance for that service then no doubt the doc charges you/insurance for that.  It was a nice way to gain revenue a few times a year over once a year.

Basically ask your doc, whether they admit it directly or not, the reason may be that your insurance wont pay for it.  That or your device is not supported.

I certainly wouldnt worry about it but there are a lot of folks that do worry and that is fine.  

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The experience of having a couple of lengths of wire fed into your heart muscle and an electronic 'box' tucked under the skin is not an insignificant event, but you will survive.