Pacemaker Replacement Surgery

I'm assuming that when they replace my pacemaker it's going to be an outpatient surgery. My leads are still good thankfully. I see the surgeon next week so he'll likely tell me for certain then.

What would make pacemaker replacement an inpatient surgery? This is my first replacement. I'm hoping it's outpatient but even if it's inpatient it's fine.

My pacemaker is almost old enough to drive in some states 😂. How much have pacemakers changed in 15 years and can one have MRIs if necessary? 


6 Comments

Hi Dendro

by Lavender - 2024-10-08 21:07:25

Pretty cool that you are the proud owner of a teenaged pacemaker. Congrats on your long history together!

Some with replacements were only in the hospital part of a day. Some longer. Your EP should be able to tell you how long you can expect to be there. 

What I understand is that new pacemakers are ok for MRIs but the thing is whether your leads are ok for MRIs too. 😉

Day surgery

by piglet22 - 2024-10-09 05:03:32

In theory, there's no reason why you couldn't go in early morning and leave in the same day.

Both my first implant and replacement involved overnight stays.

The replacement took about an hour and frankly was exhausting as I was 100% dependent and wasn't externally paced.

Staying in for was rest only and I could have made it home.

The difference between first implant and replacement, was other than a ward round by the consultant, there were no checks made.

To be honest, I quite appreciate being looked after for a few hours and quite like hospital meals.

The MRI factor

by karensoftball - 2024-10-09 14:38:30

On my first PM so can't comment regarding replacement. But will chime in on my MRI experience so far just in case it can help anybody.

Long story short, even if both leads and PM are MRI safe it still might depend on location on the body as to whether the MRI is the best option.

We have family history and genetic mutation on both sides of the family for breast cancer. I also tested positive for mutation and some other factors so require additional screening to be safe. This came up just after I got my PM.

This area of the body would require the MRI to be at a lower setting, but I was advised the image quality would not be suitable for decision making. We are exploring safer options.

Didn't mean for this to be an over share but one of those things that likely isn't thought of when we get our PMs.

Report back

by Lavender - 2024-10-09 16:52:00

Let us know how it goes. We all will eventually go through pacemaker replacement. May your experience be an easy ride!

replacements

by Tracey_E - 2024-10-10 11:42:39

I'm on #5. The only time I stayed overnight after a replacement was when I got a new lead. The others I was home fixing my own lunch. Replacements are super easy!

similar

by dwelch - 2024-10-24 01:20:02

Currently Tracey_E and I have been at it about the same amount of time

37 years paced, device number five.  I have leads that are just about old enough to be able to have grandchildren.  My current device is MRI safe but most of my leads (have four using three) are over 30 years old.  My first doc was very clear no MRIs and I have stuck to that but due to this site, im not sure.  The tech on both sides has improved, but after all these years you cant even get the stress test folks to talk to the cardioligist folks.  Much less some other doc to talk to any other doc or either of them to have the experience to know if you are safe.  If someone puts me in one and it rips holes in my heart, then hopefully they will either have a surgeon close by or it will be quick and painless.

On a  happier note.  The first device is the hardest, you know nothing, you can read all the posts you want, but you have to live through it.   Second, third, etc are easier, one of them I thought I was such a pro and ended up with a stiff shoulder and that really sucked. 

My first docs rule, was new leads you spend the night.  So first device yes.  Seocnd device, he broke a lead so I got a new lead, spent the night. Three and four, in and out in like 3 hours plus or minus, back home.  Device number five though, adding a new lead to get a biventrical (three lead one A two Vs) pacer, so spend the night right?  End of the day it was my decision, someone, either an intern or not a doc was too busy on his phone to really talk to me was basically asking if I wanted to stay.  He wouldnt bother to let me know what the doc said.  I chose to stay the night.  I had waited hours to get the room, my ass had barely touched the bed, you ready to go home, no we waited for this room what are you talking about.  

I have had five but honestly cant remember much of the recovery, it is like a drop in the ocean relative to the life of that device (if yours is a teen, you rock! mine rarely get past single digit age, just unlucky).   What I remember and tried to remember for this site from the last one, is night one sucks, embrace the suck it is a lot of trying to get comfortable and get through it.  Staying the night I did get IVs a couple three times, antibiotics maybe (Tracey_E probably knows) and I did get an interrogation in the morning.  None of which I would have had had I just gone home.  There are all the cons of being in a hospital, etc.  There is no right answer, but the rule I was taught which may or not be valid, is new lead, you spend the night.

Otherwise, a few hours and you go home.  Yeah really.  Like 3 plus or minus. Open the pocket, unplug the old, plug in the new, sew up the pocket, wait for the paitent to wake up, okay go home.  (and embrace the suck for night one).

I never owned a recliner, but reading other peoples posts all these years, I am going to look into renting a recliner if nothing else for the next one.  I am pretty tall so they just dont make them my size which is why I never bought one, tried out dozens of them over the years.  Anyway, that is someones pro-tip that sounds like a great way to get through the first so many days.

It the next week so maybe you already had your procedure.  Hope it went well, let is know.

Because of my situation on number five, going into a biventrical, Im a big guy and already had three leads, using two, now facing four leads using three on one side.  preserve the right side, use the right side, etc, etc.  My wife said on number four that I talked to the surgeon afterword, for a while, I dont remember it.  I was still drugged.  So I specifically asked ot talk to the surgeon (my EP and Surgeon are not the same person), and we talked about four on a side or what happens if not, what if we dont save the right side and move over what happens to the left. If four dont fit when does the broken one come out, etc etc...one through three the EP was the surgeon.  My oldest lead will likely be 40 when I get number six, so no doubt I am going to have a sit down with the surgeon and EP and find out how many surgeries and what done when and all that.   Short story, if your EP/handler is not your surgeon, then see if you can have a pre-surgery meeting, and get a feel for pros and cons or rules for staying the night and other possibilities that are known to them but we have no clue.

Look forward to hearing how it went.  stay the night or not, is a very good topic.  and it likely varies based on insurance or what country you live in, docs, etc.

 

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Member Quotes

I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.