Battery End of Life and Safety Mode

I had originally posted this as a response to another person with a battery concern. I am reposting to the general battery forum since it seems to pertain to some other posters.

I am now at 3 months before my battery end of life. I have a Medtronic dual chamber for bradycardia and other issues. I pace 95% of the time in one atrium and 45-55% in the other. I have it set to adjust to pace more/at a higher rate when I am exercising (called adjustable mode, I think). This will be my first battery change.

I thought I could schedule an appointment to have my battery replaced BEFORE the safety shut down, but my cardiologist told me that by law, he is not able to schedule the battery replacement procedure until the battery actually goes into battery safety mode (my heart rate will go down to 60 beats per minute without any warning). 

My cardiologist said the safety mode would be obvious to me as I would likely feel the change in my heart rhythm as it slows down and have the following physical responses: difficulty going up stairs, difficulty breathing during exercising, fatigue, and possibly other symptoms.

I wrote to Medtronic to complain as this seems to be very inefficient in a busy, modern age. They responded that it is my choice what rate I want my heart to beat at...even though we have NO choice as to when the battery goes in to safety mode. No one has been able to tell me who made the law. I understand this feature was originally created to keep people alive until they could get their new battery, but it seems like it would make sense to schedule it...Another issue is that I will have to deal with my new year medical insurance reset and pay out of pocket due to my deductible since it didn't happen in 2023.

Tracey has always been a great source of information, but I see that she was able to schedule her procedure...I'm not sure if this battery save mode is specific to Medtronic or if other manufacturers have the same preset. I'm wondering if others are able to schedule their battery replacement or if everyone has to wait until it goes into safety mode before getting their replacement battery?

I admit to being anxious about this situation. I have a very busy work life and a daughter with special needs. My cardiologist assured me he would do everything possible to replace the battery within a couple of days if he or is colleague are able to free up their schedule, but it still means missing at least a couple of day of work before the procedure and feeling sick when my heart rate goes down. He doesn't think it will require much down time at least.

I wake up every day wondering if today will be the day it shuts down. It has been really hard! I've let close family and friends know. The hospital won't release me without an adult present due to the need for anesthesia during the procedure so this is another complication.

I'm at the point of acceptance (while still frustrated to be in this situation) and am trying to joke about it, but it is still nerve wracking waiting for it to happen.

The good news is technology has advanced and the new battery is supposed to be better and have a longer life than my current one. If all goes well, I will get a new pacemaker and leads in another 10 years or so.

My best to everyone.



Hope all goes well for you

by Gemita - 2023-12-29 04:31:27

Susan, I have yet to face a device replacement.   I am in the UK so we have very different health care systems.  I expect and hope that my doctors will be guided by my “symptoms” as to when and how urgently I might need a device change and I think your team should be too?  

I too have a Medtronic dual chamber pacemaker.  According to my pacemaker manual for my Ensura model, when I reach elective replacement indicator (ERI) period, all pacing parameters can still be programmed, including mode and rate.  Reprogramming the pacing parameters may reduce the duration of the ERI period to EOS (end of service) period though.  I am presently mainly atrial paced.  It appears that at ERI time, my mode would automatically switch to a ventricular pacing mode at a lower rate of 65 bpm (am currently paced at 70 bpm).  However, as mentioned, this can be reprogrammed during ERI, so that is what I suggest you ask for since I note you were told by Medtronic that it is your choice what rate you want your heart to beat at?

Susan, if my understanding is correct, I think you meant you pace 95% of the time in the right atrium and 45-55% in the right ventricle?

Good luck and please keep up the pressure to have your doctors keep a watchful eye on you and you do the same and report any difficult symptoms as soon as possible.  I hope your device change goes well for you.  Everyone keeps telling me it is so easy.


by piglet22 - 2023-12-30 06:44:26

I find your story unsettling too.

Your care should be dictated by your needs, physical and emotional, not by law..

Having had a replacement after device misfunction through premature battery failure, I can tell you that any well intentioned safe mode goes out the window.

Emergency admission to A&E was the order of the day.

I've related this before so won't repeat it. Whatever monitoring my medics did, it was insufficient.

As for the EOL safe mode symptoms, I had none of those. Involuntary muscle twitching on the left side were the symptoms I had.

When your arm moves at 60 twitches a minute, you know something is wrong.

As a result, with a second replacement on the horizon, I am slightly less confident in my team than I was before.

If you  are in a position by do so, as soon as I got a firm confirmation that EOL was nigh, I would be doing weekly downloads whether they liked it or not.

The last thing you want is something going wrong halfway across the ocean.

I was expecting an organised admission, but that never happened.

I agree!!

by PacedNRunning - 2024-01-03 18:06:07

I just went through my first battery replacement and it was stressful waiting for the ERI to signal it's time for replacement.  I'm not sure where you are but in the US, the insurance will not allow replacement until the ERI indicator happens. I agree with you, it should be changed out before low battery mode.  I have Boston Scientific and this safety mode or I say when it dials down doesn't happen for Boston until I reach EOS (End of service).  This is when It paces to keep you above 50bpm for Boston. Each brand is different. Medtronic I believe is the only brand that dials down at ERI. All others wait until EOS. It would help if Medtronic would change their algorithm to match other brands and not dial down until EOS.  Thankfully, I have a great doctor and he was able to have my battery replacment approved before I reach ERI.  I still had 3 months to ERI when I had a new battery placed.  I hear you saying they will get you in ASAP once the indicator happens. Hopefully it will be a couple of days like they said.  But I agree 100% with you, they need to change this and make it convenient for us once we reach either 3 or 6 mos of battery life remaining.  Especially for us that rely heavily on the device.  

same situation

by natalie - 2024-01-09 15:21:53

Hi Susan, I also have a Medtronic dual for bradycardia.  My PM will be 12 years old in March. My doctor planned my replacment for December but at time of surgery, I still had 5 months left on my battery.  If I had medicare, he would have been able to do it? But since I'm only 57, I have to wait for the ERI.  

I was also told when it moves to ERI, my heart will be paced at 65 beats by the ventricle. But currently my ventricle lead only has to  "work" 1% of the time.  Will this change and keep heart rate at 65 100%?

When does ERI take over?  Will it be in 4 months or 5 months? Or is it not that clear?



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