Micra and Old PM

Hi, I have posted lately because my PM went into end-of-life mode. My surgeon had to (inexplicably) cancel his surgeries and they found an EP to replace mine; the new surgery date is this Friday.  In the mean time, this pacing is horrible!  Anyway, I was reading previous posts about the Micra.  What do they do with the old battery?  Does it have to come out or can it be just turned off and left in?  I am wondering because I am scheduled for major surgery a week after the PM replacement and would like to avoid additional incisions....



by dwelch - 2020-07-08 01:08:02

When folks say battery is because other folks say battery because some docs say battery. 

The whole pacemaker gets replaced, the battery is not removable/changeable.  Look at images of pacemakers on the top the leads are pushed in and held into place with a screw or screws.  The whole thing is packaged in a sealed metal case.  

They open the pocket pull the old one out pull the leads out put the leads in the new one and put the new one in the pocket, if everything looks good sew it up and done.

Because of our use of lawyers over time, you cant get your old device back.  I have my first three but was not able to get number four back.  There are situations where others can get it on your behalf but you cant have it (like it is possible evidence in a lawsuit, then the law firm can get it with the right paperwork).  The place where my last couple were done they hang on to it for a couple of weeks in case a request comes in, then they destroy it. YMMV

So battery replacement means actually pacemaker replacement (but not leads so the surgery/procedure/risk/etc are all much less), and what they do with the battery (pacemaker) is keep it and probably destroy it.  Now if they create a lead problem (my doc broke one during a replacement) or detect a lead problem then at that time they will put a new lead in and you may need to spend the night depending on doc/practice/hospital/active pandemics



by PacedNRunning - 2020-07-08 02:47:36

For the Micra pacemaker.  The old ones stay in. They don't have a way at this time to remove them. They just turned them off and drop a new one in. Only certain types of conditions qualify for the MICRA.  Simple bradycardia quality. Chronic AFib with no SSS qualify.  They now have the micra AV that just came out this year.  I don't qualify for the MIcRA because I need 2 leads.  

Maybe a better answer

by Protimenow - 2020-07-08 04:39:29

The previous comments didn't really address your question.

If you're scheduled for another surgery a week after your Micra is scheduled to be replaced. 

You didn't say what KIND of major surgery you'll be having, but mentioned something about incisions. 

If you could put up with the pacing issues, perhaps you can wait the extra week and get both procedures done under one general anesthesia. 

OTOH - if you're having problems with the current pacing, you may need to have it replaced ASAP.

FWIW - if the major surgery is not an emergency procedure, they may put it off because of the surge in COVID-19 cases - they may not have an O.R. available in another week or two. It may make sense to get the PM replaced while you can, and then see what happens with scheduling of the other surgery.

Minor correction

by Protimenow - 2020-07-08 04:44:23

I just looked up information on the Micra. As a transcatheter placement, this shouldn't be too big a deal. It's not like getting a pocket cut in your upper chest and having a PM inserted in the pocket. This involves a cut, probably in a femoral vein (in your groin), then placing the Micra through a catheter. The issue of a scar or incision shouldn't be a big deal. 

This may make you stronger, more ready for surviving your major surgery.

Good luck with your surgeries.


by camilamadison - 2020-07-08 05:14:28

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by Tracey_E - 2020-07-08 10:13:27

If I'm understanding correctly, you would like to have yours replaced with a micra? If you currently have traditional leads, you don't qualify for a micra unless they took out everything you have now which would mean a much more involved surgery. 

If your leads are in good shape, replacement is super easy. They usually go in same place as last time so it's all scar tissue. 

Yes, pacing in EOS mode feels awful! It's good they can get you in sooner. I would ask about doing both surgeries at the same time, or at least during the same hospitalization. I did that on one of my replacements (I'm on #5). I was admitted for something else on a Sunday. I already had tests scheduled Monday for a replacement the following week.  The ep was able to bump it up and get it all done while I was in the hospital. I just did it that way because it was easier, but Covid is even more reason to get it all done together if possible because of exposure. 

Last word??

by Protimenow - 2020-07-08 13:31:52

I've re-read this, and read the comments. 

I think I have the answer:

If you qualify for the Micra, it doesn't seem like a big procedure - the only skin that is cut is to get the catheter into your groin to route the Micra into your heart. IF they put the Micra in, they'll probaby just turn off your current pacemaker and leave it in. Remember that PMs are very tightly sealed - they are designed to be left in for many years - they're not going to leak; they won't do you harm by sitting in their little pocket. You won't have to get the old one replaced - so there won't be any incisions, wound healing, or scar tissue to worry about. 

But that's if your condition qualifies for a Micra.


qualifying for micra

by Tracey_E - 2020-07-08 14:57:45

If you have leads in the heart now, you do not qualify for a micra.


by Yakkwak - 2020-07-09 13:27:00

Thanks all.  Rec'd partical information from a Medtronic rep. Barring patient-specific contraindications, the device is reportedly designed to be implanted even if you have old leads. They do not! recommend lead removal (which can be complicated - trust me, I know from personal experience - ended up with pericarditis).  They did not address whether the old generator is left in.  I left a message for my EP the other day but haven't heard back.  So, when I go in for the procedure 1st thing tomorrow morning, it will be a surprise.  Hmmmm.  At least now I will get cardiac clearance for my spine surgery (that's why it wasn't done at same time).  


by Tracey_E - 2020-07-12 10:35:02

How did it go? What did you get? Hope you are feeling stronger and ready for the back surgery. Thinking of you!

You know you're wired when...

Bad hair days can be blamed on your device shorting out.

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