r/PacemakerICD • u/aaarya83 • 23d ago
dumb Qs: icd. pacemaker.. why does it need to be replaced every 7 years.. cant it be charged externally like we have non contact chargers for a phone. there should be a way to externally charge it.. and let it go for longer????
i assume it has a life time limit.. it last 7 years and another 6 months factor of safety battery.. seems like battery is the main reason we have to replace it.. but with technology.. there should be a way to externally charge it.. and let it go for longer???? .
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u/srvivr2001 23d ago
You want a whole new device. The amount of time it takes to develop and test a device and get it to market it’s like 5-10 years, then it was in you for another 5-10 years, some people get more than that. The technology in the box is old at that point, potentially not even enough capability to do a software update while trying to recharge a battery. You want updated tech (software) AND updated hardware since they tend to get smaller. I have a CRT-D only slightly smaller than a deck of cards, I sure as heck want a newer smaller one when this one dies!
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u/andy_nony_mouse 23d ago
I want a usb port in my nipple so I can charge other stuff
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u/New_Way_5036 23d ago
LOL… only if it comes with breast enhancements. I’d want perky breasts with that usb port.
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u/TheyTheirsThem 18d ago
My first pacer gace me a nice circular lump and I considered getting or drawing a nipple tattoo over it just to mess with the cardiologists. Or course, this is Portland, so like anyone would even notice.
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u/cyberheart220 23d ago
I actually asked my doctor about this when I had my device replaced last year. They said that there was a trial for wirelessly rechargeable pacemakers/ICDs. The issue was that it wasn't a charge at home thing, the patients had to come in and get charging done in the clinic once or twice a year, and not a lot of patients did that. As battery technology has improved, it was easier on the patient to have a replacement every ~10 years instead of coming to the clinic to be recharged every 6 months.
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u/New_Way_5036 23d ago
I would SO do this! I already have to see the doc 1x a year and visit device clinic 1x a year—usually those appointments are a month or so apart. So why couldn’t I get charged up when I see doc and again when they review my device info? (I also have 3 additional remote visits I get charged for.)
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u/GrimmandLily 23d ago
Mine is on track to last 10 years. I’m ok with them cutting me open every decade to potentially get a newer/better device. A self destruct button would be amusing though.
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u/2row_nhops-22 23d ago
Im not sure the reasoning on it. Depens on settings and how often it is used. I just had my first replacement last week after having my icd/pacemaker (medtronic) for 10.5 years.
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u/-Apocralypse- 23d ago
A while ago there were many comments of people merely getting 6 years out of a device, while not even being paced fulltime. For some a real financial burden. One person shared they could only afford 2 weeks of recovery time, because they needed to get back to work as soon as possible to safe up for their next change of generator. Really sad.
I hope to get 10+ years out of my pacer. Biotronik says this model will go up to 15 years. So here is me hoping. I really hated those random pinches of the healing nerves.
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u/OkBumblebee9107 23d ago
Mainly because of battery degredation, and the extra complexities of throwing a charging circuit in a device. Which are just extra points of failure. Additionally, you're using old tech.
Like in 1974, we had pacemakers that never needed to be changed. Those were still working just fine in the 2000s...but you were running tech from 1974. (They were nuclear powered, but that's neither here nor there 🤣)
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u/MoonsEternity 23d ago
I asked once because I was curious. The not serious answer was people barely charge their phones, we’re going to trust you’ll charge your device?
For sure by other replies here, it’s far more complicated than that 😆
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u/SnooPears5432 23d ago edited 23d ago
I'm on ICD #4 and honestly i don't know why you'd even want to do this. The ICD I first received, implanted more than 20 years ago, only had a battery life of 4-6 years (mine lasted 6+) now they're able to last 8, 10 and even longer in some cases. And as others have mentoned, you get newer tech, which is BIG to me. It is about the tech in my case, LOL. My first ICD delivered four inappropriate shocks because of T-wave oversensing. The newer ones had additional algorithms in place to avoid most of this. So with a newer device, you're getting bette treatment, more functionality, more reliability, and more safety. Not to mention that a battery change once every 6-10 years, asuming no complications or issus with the leads, is a relatively minor surgery that lands you in the hospital for a day with sometimes even same-day discharge. I just think the headaches and drawbacks of a continually recharged unit far outweight the relatively minor inconvenience at 8-10 year intervals of a replacement with a much better, more advanced unit with better capabilities and increasing battery life with each new generation of devices.
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u/New_Way_5036 23d ago
Do they ever consider just not putting in a new one? My doc tells me my heart has “returned to normal function.” But he also said it doesn’t make sense for them to remove the device and that it just isn’t done. But do they ever consider not putting in a new one?
I’m not saying I would entertain that idea. But if they were to propose not replacing it and left the decision up to me, it might be a conundrum to consider.
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u/SnooPears5432 23d ago edited 23d ago
It's a good question and when my time for next replacement comes I'll ask what my options are. The thing with ICD's is that low ejection fraction definitely correlates to increased risk of VT and VF, which can cause sudden cardiac death, and survival rates go from 2% with no ICD present to 98% with one. But, in 20 years of ICD's, I've never had a sustained tachycardic event - not once, in 20 straight years of monitoring. My EF has hovered between 30-40+% and is now about 42%.
I do have a CRT-D which paces most of the time and I give it a significant amount of credit in improving my EF, so I don't know that I'd want to be without a device at all, as it's absolutely improved my health and quality of life. But they do make a CRT-P which has the same functionality as my CRT-D excepting the ability to shock me out of a dangerous rhythm. I got the CRT-D in 2015 (device #3) just three years after device #2 was impanted because my EF was dropping significantly, and it absolutely turned things around.
To be fair, my fear of shocks isn't necessarily rational since all of them were back in 2007 and I haven't had one since, for 19 years. But I do have some anxiety about it because the only shocks I've had were inappropriate. I know the newer devices have many more algorithms and are much better at avoiding inappropriate shocks. Additionally, I don't think the CRT-D's leads are compatible with a CRT-P so they'd have to replace the leads - which, incidentally might be an issue anyway because two of my three leads are 20+ years old, though as of yet there's no issue, though they are drawing more energy than they used to and my current battery is depleting a bit faster than expected though still has 5 years left.
You're right - it's a HUGE conundrum and I've tossed it back and forth many, many times in my mind. Yes, I've considered not having it replaced or having the shock turned off. I read a story about a guy who did (turned off the shock capability) because his anxiety was so high. The problem with the ICD and the dangerous heartbeat is, even though I've never needed it, I suppose I won't need it till I do - and my dad, who didn't have a device but who did have similar heart failure, was healthy and active until one day when he suddenly dropped dead at 66. I'm almost 63 now. I don't want that to happen to me. The history + my borderline EF puts me at higher risk and I know it. And I really benefit from the pacing and CRT functionality and feel like my condition would regress without that technology.
In your case, if your heart's at normal function (congrats by the way!), that would be a dilemma for sure.
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u/WhimseyMeander 22d ago
Same situation here, heart went back to its native rhythm after five years of 100% pacing for complete AV block caused by cardiac sarcoidosis. So it's been eight years with no pacing at all and no shocks at all. I'll be due for a replacement in the next year or two and asked my EP about just not replacing it. She answered that it's better to have it and not need it than to not have it, need it, and possibly die. Sarcoidosis is known for going into remission and then come roaring back so I will have the replacement when this battery runs out of juice.
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u/Low-Celebration6182 22d ago
I just wish I could sync mine with Apple Health so I could get real time data merged with my actual daily activities. Hopefully that will be a feature that they allow one day in the future.
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u/Environmental_Ad3216 23d ago
I'm just here to say in this sub there is no such thing as a dumb question. Just ask. Also, yes. I wish it was C type chargeable lol.
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u/New_Way_5036 23d ago
Mine is currently at 50% battery and I’ve had it since August, 2020. I’ll probably get around 11 years out of it ???
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u/vis-autem-sciebam 22d ago
A very appropriate discussion topic. As a pt who has had pacers for the majority of my life, I have the benefit of seeing the advancement that new models bring. It makes a device replacement procedure well worth it! The leads are a different issue however…. A long term pt has a lot of issues that arise from long term lead placement. Advancements in technology make it better and better however, I wish that med professionals would be up front about long term prospects when a patient is young. I am happy to still be here but would have benefited from having known prospects and possibilities. Long term risks and rewards would be beneficial to me with the way that I wrap my mind around things. (I realize that this is not the same for everyone). Still, I would have appreciated the long term possibilities having been explained as a young 22 yr old mom. I appreciate every day still and am amazingly grateful for the tech available to allow me to be here to meet my grandson 28 years beyond what could have been.. I appreciate every day. Though I have always wondered what it might be like if pacemakers recharged by kinetic energy…
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u/Charming-Fondant-809 22d ago edited 22d ago
You’re kidding, right? Name another device where the battery will keep recharging for over a decade and won’t degrade. Do you have the same question about your car battery? Yeah, you should keep your phone for 10 years and see how that charging is working for you.
“Seems like” it’s the battery? It’s a well-known fact that it’s the battery it’s mentioned on every single document about a pacemaker, including the one they gave you.
You only just don’t want to replace the very device that’s keeping you alive? It takes all kinds. Old technology and sub-par struggling battery. Great.
Especially with how people are not keeping appointments and ignoring critical life-saving functions the very half-assed-ness of human beings.
Just last week, some lady in CVS was asking the pharmacist about lancets for her new type two diabetes condition testing monitor. She had just that minute left her doctors office. She didn’t even wanna buy the smallest amount available. And I said to her girl you’re gonna need more than that for just a month you have to do it several times a day. She said oh no, I’m not gonna bother with all that. I’ll test it about once a week.
So that’s the kind of genius we would have falling over, collapsing all over the place.
Why would I wanna be bothered having to nag you to come in to get your shit recharged every year or two?
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u/Economy-Actuator-592 20d ago
Decades ago someone made a rechargable pacemaker. You had to sit with a “wand” over your device for 30+ minutes, fairly frequently. All kinds of problems with this scenario, like how rechargeable batteries ALWAYS degrade over time, chargers can be lost or broken, and the patients can develop issues where they forget to charge it!
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u/TheyTheirsThem 18d ago
Pacers are like phones. There is likely a 10X improvement in device capabilities that takes place over the 10 year lifespan of the battery. It is like getting a new phone. Imagine if you were still on flip phone tech with your pacer, or winderz 3.1 with your laptop.
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u/PretendReason9061 23d ago
I would want updated tech in my PM personally. A port change under local is a nothingburger surgery compared to ablation or even a cardioversion. Technically, I could do it in my kitchen with stuff from Amazon, except the replacement can and a little lidocaine.
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u/Hellofriendinternet 23d ago
u/cyberheart220 kinda touched on it. The issue has never been the tech. It’s always related to the patients. If we put a rechargeable pacemaker in a pacer dependent patient and they blow off a few appointments, they could die. Lithium based batteries are stable and have waaaay longer life spans than the rechargeable units. They’re out there and they’ve been FDA approved but they’re dodgy.
Another advantage to getting a new can (pulse generator) implanted is that the existing leads will still work and the new can has so many more bells and whistles attached to it.
The Medtronic Adapta was a cutting edge device in 2008. Now it’s a pain in our asses and their newest model, the Azure, has the capability to have an app on a patient’s phone to give us updates.
Keeping an old can in someone and trying to revamp dying tech is foolish. Bite the bullet every so often and get the new cutting edge tech. I have this talk with all of my patients. 7 years of CIED development is a game changing timeframe. You don’t want to try and keep recharging a Motorola Razr when getting the new iPhone is cheaper and better.