Battery life coming to an end

My pacemaker was implanted in 2010 and they said it had about 10 years on the battery. We're at 12 years now and the transmission report shows 5 months of battery life. My concern is that we live 30 minutes outside of a rural town (12 bed hospital) and how to plan for the possibility of it failing while I'm home. The hospital that would replace it is two hours from my home. We also live in snow country and five months from now is winter so that's another concern. Initially in 2010 I passed out, my heart stopped and no pulse so my husband called 911. In the ambulance and hospital my heart rate was in the 20s. We have no idea what to expect and we might just get lucky and have no issues until they replace the battery. My husband is taking a CPR refresher course, but I'm wondering what some of your experiences have been and how you planned for the battery replacement. They won't do it early because insurance won't cover it. We also knew at some point we would need to move closer to a town with a decent hospital, but COVID kind of changed a lot of plans. We've both been very healthy other than my pacemaker so we were enjoying the rural life. Thank you for reading!


battery end of life

by new to pace.... - 2022-09-15 05:18:15

Sorry about your concernss.  If it was me i would move temporarly to be closer to the hospital.  While waiting for the battery change.  Then return after the battery change and  after the first the check up.  Hopefully you can then relax.

new to pace

Battery change

by Good Dog - 2022-09-15 08:06:59

I think that it is important to know that what happened the last time and the reason you did not die is, because you have an escape rhythm, albeit very low, that kept you alive. I experienced a similar situation when I initially went into complete heart block, but I did not pass-out. My HR was as low as 12 bpm in the ICU. It was my escape rhythm that kept me alive.  I am not suggesting that it is something you should want to depend upon, but just a little reassurance that if your battery were to go dead, which is very, very unlikely, it is also unlikely that you are going to die. I am not saying that you should throw caution to the wind, no, definitely not. However, the reason I say it is unlikely is, because your PM has at least a 3 month safety margin built-in. In actuality, it is even longer than that. The worst thing that can happen is that if it goes into end-of-life mode, it has a battery saving feature in that it will pace only the right ventricle for three months. So you would have at least that amount of time to get to the hospital. A battery (generator) change is a piece of cake. Not a big deal. Just follow your doctor's orders. 

You have actually received a significant amount of longevity from your battery, which is really good and that would indicate your heart is in pretty good shape. So here is the thing, contact your Doc and explain your fear. Simply tell him that you want to get in for a battery change as early-on as is possible when the battery reaches the "elective replacement period". The ERP is for insurance purposes (those dreaded insurance companies), but sometimes a Doc can get an exception and get you in slightly ahead of elective replacement. You have to ask and explain why. Explain your circumstances and your fears. 

I am not suggesting you shouldn't have fear, we all have that. Or at least we should if we are normal! My point in all of this is to alleviate your fears. Fear is usually a good thing, but we need to be realistic. Talk to your Doc and rest assured that there are enough safeguards to prevent the worst case scenario.

I wish you nothing but the best, and please come back here after your battery change and let us know how it went.





by Tracey_E - 2022-09-15 09:22:26

I'm on my 5th, so been around this block a few times. Do not worry!!!! There are built in safety margins, it's not going to suddenly stop. 

Ask if the insurance will replace it during ERI. "Not replacing early" could mean not before it gets to ERI, no one will do that. Or it could mean you have to wait for EOS, if so see if they can make an exception due to your very low underlying rate. My underlying rate is also 20's and I've never had trouble getting insurance to let me do it when it's ERI. 

Do you have a home monitor? If so, that makes checking on it easy to see where you stand.

If you are under 6 months left, they should be checking every month. 

What's ERI and EOS?

It will not suddenly stop working. The first mode at the end is called Elective Replacement (ERI). This is like the gas light on in your car, it still runs normally but you know you need gas soon. This mode lasts about 3 months and if your insurance allows, schedule once it gets to this mode. It's not an emergency, you can meet with the surgeon and pick a time that's convenient.

At the end of ERI it switches to EOS (end of service) which also lasts 3 months. At this point it's going to cut back all the bells and whistles to conserve power but it will still keep us safe. It paces at a steady rate, usually 60bpm. If you pace a lot, this is not going to feel good, but you won't pass out either. 

Ask them to clarify, do they mean 5 months to elective replacement. That's probably what they mean, but verify that you are not yet in ERI. 

And if you didn't know, replacements are super easy. Leads usually last through several devices so they just go in the same place as before, pop out the old one, test the leads, attach the new one, close. Most of the pain the first time was from making the pocket, most of the restrictions the first time was leads healing. This time, the incision just has to heal. If I get an early appointment, I'm home fixing my own lunch. Last time I took a little nap then answered some work emails that afternoon. Twice I left for vacation less than a week later. Easy, peasy. 


by Tinawired - 2022-09-15 13:12:40

Thank you for your reassurances and great explanations! I'm not sure why my doc and pm nurse didn't mention ERI and EOS/EOL, but now I know.


by Good Dog - 2022-09-15 18:49:39

That happened to me. I did not get a notification, but when it went into EOL there was no doubt about it. With a steady rate applied only to the right ventricle, my heart was so out-of-sync that I felt just awful. Much like your daughter, you will realize it is time! Thing is; when it goes in EOL you still have three months. It may not feel good, but you are not in any danger for three months. If the PM is monitored more frequently as it is nearing the end of the battery life, there is almost no way you will not know you have reached that point even if you get zero notification from the device. So; not to worry!

Good info

by Tinawired - 2022-09-16 00:33:07

You have all given me great info. I will be sending a monthly transmission and my next one is October 1. I'll do some research on my Adapta pm and try and find out how it works at the end of battery life. The insight you've given me has helped was we my mind. I'm not overly worried, just trying to have a plan in place. I'm very glad I remembered about this group. I think doctors sometimes forget that their patients don't have the same information and experience that they have. I really wish they had simply addressed my concerns with facts about my pm, but hopefully this conversation might help others down the road. I'll keep you posted!

no concerns here

by dwelch - 2022-09-20 08:03:26

I do not see any concern here.  Many folks live hours away from facilities, I did originally for my first couple of devices.

If your device is reporting months then you are on the final stretch for that device.    The doc should be doing some form of test every month or every three, if you have one of the take home boxes, there you go.  The old days it was a phone box, or before that you just went to the office more often for a full interrogation.  (I have had devices for well over 30 years, like Tracey_E I am on number five).  

Even when it gets to lets say zero, then you still have months to replace it.  You are not several months travel away from the doctor, so there is nothing to worry about.

Even without the monthly or quarterly check, as mentioned by others, it goes into a mode which sets you at a fixed heart rate, keeps you alive for ... months. ....  Depending on your health you may feel this, trying to exert yourself, climbing stairs, carrying stuff, you wlll feel unusually out of breath and out of energy.  Check your pulse.  if it does not change, is say for example fixed at 65.   You are now beyond elective which these days insurance companies want to save some pennies and are wanting to force us all into this safety mode before replacement.   If you are super healthy, etc you might not notice this.

I have had three of my four replacements go into this mode.  One of the three I actually noticed.  Most of my pacer life insurance has limited the testing between office visits, and limited the number of office visits per year, so in one case it was every 6 months, another every 3 months, and then one or two docs were willing to cover the cost of every month.  Now there are these take home boxes, but they are if nothing else a revenue gathering industry like the early phone check boxes (a third party manages the devices and charges the docs/insurance with a fair amount of profit). 

The many device folks here are kinda rare since most folks dont start in their youth, but a big percentage of the folks here have had more than one device.  It is awesome that yours went 12 years, I hope they keep finding you excellent devices like that one.  Probably also an indicator that for you and that device the lifespan of the battery after it switches modes is longer than for some of the rest of us.   This is not like other battery based devices you have, there is engineered margin in there, it is a medical device not a electric car or mobile phone or laptop.

two hours away is no big deal.

The action you can/should take right now is ask the doctor if they and your insurance allow for elective replacement.  Basically can we replace it now or do we have to wait?  The 5 months estimate is still an estimate it could still go for a year or it could switch modes in less than that time.  In the old days, your situation would be easy, lives in the rural area, winter is coming, device is reporting months, replace now.   But according to my doc, insurance is pushing to wait for it to switch modes, getting a few extra months out of all of us and saving that money on devices.  

So call your doc, find out what the story is, tell them your concerns, if they are any good they will assure you that you are in no risk of the device shutting off.  Are we in a time window that we can replace it sooner rather than later.  I suspect that you are not their only lives far away patient, they probably have many, and this is nothing new for them.  

Your concerns are very normal most of us have been through at least one device replacement, and experienced the anxiety of the battery getting low.

Battery end of life

by Tinawired - 2022-09-21 12:08:43

Some of you have mentioned talking with my doctor and I was finally able to. The situation I'm dealing with is she is wonderful, but very understaffed. Just her and one staff member and I only found that out after I wasn't able to reach anyone or get anyone to call me back. I'm currently looking for a new doctor. I did call Medtronic and my pacemaker doesn't vibrate or do any notifications, but it has an ERI and 3 months of life beyond the ERI. I will have a pulmonary function test next week as I am so short of breath the past couple of weeks. I can't run anymore and that's a new development. My trip to the ER on Labor Day showed no pneumonia or any other serious lung issues and my blood work was good. I'll send my monthly pm transmission on October 1. Thanks again for the support, info and advice.

I’m nearing the end.

by PacedNRunning - 2022-11-08 04:42:39

Hi. Maybe you've had your replacement by now. But wanted to say I'm going through this right now. I'm at 11 mos and was told in January I can schedule my replacement. They will not wait until ERI because I depend on pacing. Whew! I'm curious how my doctor gets the insurance to approve this but I was told, it will be replaced well before ERI. 

Generator change

by Tinawired - 2023-01-16 18:59:58

Just got my pacemaker replaced for the first time. My new pacemaker will give me notification when it comes to ERI in about 10 years. (My Medtronic pacemaker did not, it only went into the uncomfortable ERI default pacing.) I'm feeling so much better than when it was in ERI. The insurance companies seem to think they have medical expertise now and I ended up in the ER. At least it was an in-network hospital. I can't believe how little help insurance companies give you when you're trying to find out where you can go and who can help you. They need to have patient advocates instead of someone in another country suggesting you go to your regular doctor for the surgery. I told my husband the stress of dealing with the insurance company was going to kill before my pacemaker failed. The US healthcare system is a disaster. Not looking forward to the bill, but starting to feel back to normal! Hooray for a great medical team at the ER that took care of me.

You know you're wired when...

The mortgage on your device is more than your house.

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Life does not stop with a pacemaker, even though it caught me off guard.