St. Jude/Abbott alarm setting

Hi, all,

For the last several months, I've been told my pacemaker  has less than a year left in battery.

Yesterday I heard the alarm from my PM beep from my chest and it took me a bit off-guard. I happened to have my already scheduled appt. with my EP a few hours later and they said it was at 2.66 voltage and was less than 1% to ERI. They scheduled a follow-up for 3 months and said they'd continue the monthly Merlin transmissions but to call asap if I felt like something wasn't right.

I thought the alarm beeping indicated it was already in ERI.

Also, I've been told insurance won't cover a replacement procedure until the battery has reached 2.60 voltage (I have a St. Jude 2210 model). Has anyone had their doctor request an early replacement due to medical necessity? I have frequent infections so not knowing when it'll be is a bit of a gamble not knowing if I'll be infection-free. I wish insurance had like a grace period with a 3-month window in which to replace earlier or on-time.




by AgentX86 - 2023-02-24 01:07:42

Your EP should be arguing with your insurance company if there is a justifyable reason for replacement. I don't think infection risk is going to do it.  Either way, you're going to get cut so the risk is the same either way.

ERI is the three month "grace period".

I agree

by PacedNRunning - 2023-02-24 03:40:44

I don't think we should have to wait until ERI. I was told they won't let me go to ERI and I'll have it replaced before. Insurances need to change this rule. 

ERI is not the same as EOS

by Tracey_E - 2023-02-24 07:50:28

It still has 3 months of being fully functional while it's in ERI so there is more than enough time to plan replacement. EOS is when it starts to cut back. Each one lasts approx 3 months. This gives us 6 months that it will still work and keep us safe (tho those last 3 months may not feel good if we pace a lot) and why most insurance will not replace until it gets to ERI. Some insurance require EOS. I'm on my 5th and have been ERI each time. I've never had it go EOS.

I've also had it last as long as a year when it's said less than 6 months left. This is why they won't do it sooner.

It can be frustrating trying to plan and time things at the end, but it's very doable and it will work out. It is not going to suddenly stop. 

The alarm

by Lavender - 2023-02-24 10:00:59

I was told that my Boston Sci device has no alarm turned on. It would frazzle me to hear it😵‍💫

Even if you still have three months-three months of hearing that alarm would fry my last nerve. 

Always hated that insurance companies decide medical treatment 😤🤬 They also waste money which drives me nuts when they keep sending "care pkgs" of hand sanitizer, lotion, and yet another thermometer. They send Hallmark cards reminding us to get wellness checks. They send gift cards and lots of stuff. Spend that money on better care!


...sorry for your concern. It should not be this way. Having peace of mind and not waiting another three months etc, seems more kind. 


by Marybird - 2023-02-25 13:05:38

InGod'sHeart, have you actually spoken to your insurance company about their covering your pacemaker generator replacement? If not, it might be a good idea to do so, I think you might find they're willing to reimburse the costs for replacement at some point after the pacemaker has reached the ERI mode, they don't want it to go to EOL, when it's still functioning, ie, pacing at a steady 60-65 BPM but not performing any of it's other functions.

My daughter had a Medtronic pacemaker placed in 2012, replaced in 2020. They knew it was due for replacement, but like you, her docs wanted to wait until it had almost reached the end of its ERI. The EP's nurse explained to her that the pacemaker would alarm when it went into ERI, and from that point there would still be 3 months till it reached the EOL. During ERI the pacemaker still functions normally, it's a countdown, I guess you could call it, till it reaches the EOL, so you'd want to have it replaced at sometime during that ERI period.

Thanks to the vicissitudes of the covid covid covid all the time rigamarole here in 2020, my daughter's own carelessness or indifference in following instructions to send monthly, then weekly transmissions to her pacemaker clinic- she discovered her pacemaker monitor ( one of those Medtronic manual transmission jobbies) battery had died when she finally DID decide to send a transmission, discovered Medtronic's customer service to be less than stellar, was misinformed about the pacemaker alarm- she didn't have one or it wasn't set up,  my daughter's pacemaker actually did go into EOL mode. 

She's also in the category of pacemaker dependence, considering her intrinsic heart rate is an AV escape rhythm around 30 BPM- which doesn't kick in for about 30 seconds or so after the pacemaker stops. She woke up one morning, feeling lousy, with her heart rate at a constant 65 PBM with no variation,,and she knew she'd gone into EOL. That mode will keep your heart going at that 65 BPM, so you won't die but since none of the other functions work at that point, your pacemaker won't respond to your needs or physiological processes so you may feel very tired and not able to do much. My daughter had her pacemaker generator replaced about a week after her EOL, and had to take that week off work since xhe felt like a limp dish rag.

While her pacemaker was a  Medtronic, I'd think the St. Jude pacemakers would be similar in regards to their alarm notification of the ERI, followed by the EOL mode. The information my daughter got ( though she didn't have that alarm, later Medtronic pacemaker models do) was that from the time you hear that alarm, the ERI will go for 3 months, followed by the EOL, which lasts another 3 months. Your remote monitoring capability with your "Merlin@Home" monitor will allow your pacemaker clinic to keep close tabs on how your pacemaker is doing, and to allow for replacing your pacemaker generator well within the timeframe before it goes into EOL. 

I'd just check with your insurance company to see exactly what their policjes are regarding replacement.


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