Why are there no rechargeable pacemakers?

I understand that getting a new device every 10 years has benefits, and that there are other reasons to "open you up" like lead complications, but it still seems strange to me that there are no rechargeable pacemakers, or for that matter, pacemakers with longer battery lives.

Pacemakers have come down in size but don't necessarily last longer. Why are they not just slightly smaller but with a higher (let's say double) capacity?

Or for the case of rechargeable ones - I understand that you don't want this to be a daily occurance that you might forget, but there must be a battery that could hold a charge for a year or so, then getting topped up in a regular check up.

Am I missing some practical reason for why this wouldn't be possible, or is it essentially planned obsolesence?

5 Comments

This has been covered here before

by crustyg - 2023-07-26 13:24:59

Basically because a) self-discharge rate of secondary cells is still bad-to-terrible, b) capacity isn't great, c) secondary cells have well documented issues around recharging.  Fancy a lithium battery catching fire in your chest (think Boeing 787)?

Back in the day, PMs had Peltier-effect plutonium batteries (NASA use them) so had effectively perpetual battery life, but there are obvious problems with the radioactivity.  Plus the usual public hysteria about radioactivity which, while potentially dangerous is actually very well understood and pretty safe.  Many more people have suffered long-term effects from chemicals (think Agent Orange, Minimata disease, Bhopal) than from radioactivity (Chernobyl, Fukushima, TMI).

If current trends continue my PM should last about 15-16years before replacement - seems pretty decent to me (it's the bigger battery version).

lasting forever isn't all it's cracked up to be

by Tracey_E - 2023-07-26 16:18:32

Someone was working on one that recharges itself from our movement, similar to how a self-winding rolex works. I haven't heard about them in a while so don't think the research went anywhere. 

Even if it was safe, rechargeable eventually won't hold a charge anymore. How many power banks have you owned that had to be replaced?

I'm on my 5th. The one I have now does SO much more than my first. When I got my first, rate response was in its infancy, home monitors and apps were unheard of. MRI was impossible. If I was in the ER, they had to call in the rep to meet me there and check the pacer. Same for my doctor's office if it wasn't clinic day, they'd track down the rep and have me meet him. Leads are smaller, thinner, and placed in a way that is more gentle on the heart now. 

Here's a suprise for you- the one I have now is about the same size as the first one. They've gone up and down in size a bit over the years but overall stayed pretty close to the same size. This one will last 50% longer than the others, previously I was averaging 7 years and this one will be 10-11. They do make some that are smaller but don't last as long. 

Biggest changes for me personally are with my current one. It has a home monitor so I no longer have to go in every 3 months. If something doesn't feel right, I send a report and an email to let them know to look for it instead of making an appointment when the rep could be there and being seen in the office. Also, older ones had a max upper limit of 160. I regularly get to 180 when working out, and if you've ever hit your upper limit during a workout with av block, it's a bit like hitting a wall. Stop, wait for rate to come down, go back at it. Over and over. I ended up on beta blockers to keep my rate under 150 where the pacer could handle it. As soon as I got the new one, which has a max rate of 220 and is currently set to 190, I tapered off the beta blockers. 

Having been through changes, and facing another in the next year or two, I can tell you that it sounds a lot worse than it is. It truly is not a big deal. If I get an early appointment, I'm home fixing my own lunch. Twice, I left for vacation less than a week later. Very small price to pay for an upgrade in technology. I really don't want them to last much longer than 10-12 years. 

I'm currently facing a decision with my leads. I have one that was replaced in 2010 so it's getting up there in age. My other is original from 1994, and it's in great shape. Numbers on it continue to be steady. Technology on leads has come so far, odds of these lasting through another device are small, so do I leave these until they die or take them out and get the new, better (and mri safe) ones? I don't know the answer to that yet, but my point is these have lasted so much longer than anyone expected them to, and now they are obsolete. I feel that's what would happen with generators that lasted too long. They might still be going, but is it better to replace it with new and improved technology anyway? 

Thanks Tracy E

by zawodniak2 - 2023-07-26 20:27:50

As usual--Great comments and incite by Tracey.  
I will be getting Sparky #3 in a few months   Currently at 8 years and 5 months on #2 and #1 lasted 7 years and 9 months.  My last check showed orriginal leads still good after 16+ years. At 81+ years old,  I am 99.9% paced with total heart block. I have felt great all during my years with the pace  maker.  My Fitbit shows a solid 60 BPM when sleeping and kicks in nicely when exercising -- moderately that is.  
                        Rodger

Fitbit

by piglet22 - 2023-07-28 06:52:54

Interesting comment by zawadniak2 about using the Fitbit during sleeping.

I'm in the 7th month of ectopics induced tachycardia and regularly wake up with sub-40 BPM on the oximeter and as low as 80% sats. That's with pacemaker set to 70-BPM. The medics are aware but everything takes so long to resolve.

I was looking to see if I could record BPM and SpO2 overnight and get some evidence of what goes on.

What worries me is that if I ever get to see them, it will be in the middle of the day when things are normal and it will be the usual "working fine"

Rechargeable cells

by piglet22 - 2023-07-28 07:10:27

Almost certainly this would have been looked at by the major manufacturers, but as far as I know, they all opt for the primary cell technology.

Mobile phones have efficient lithium rechargeable cells or batteries and 10 years usage should be feasible. Electric toothbrushes use non-contact charging, so in theory it would be quite possible.

A stumbling block would be the recharging itself which for developed countries might only be an inconvenience, but in developing countries, with unreliable power supplies, it might be impossible.Solar cells and power banks could be a solution.

Personally, I'd rather have a device that had to be replaced and take advantage of the phenomenal rate of technology change in electronics.

I'm guessing, but increases in raw processing power and real intelligence together with nano engineering, will bring closer the day of the perfect pacemaker.

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