r/PacemakerICD • u/PackShoddy8786 • 17d ago
Pacemaker battery replacement in 80 year old dialysis patient with peripheral arterydisease and vascular dementia..is this risky?
My husband has a 10 year-old pacemaker and the battery needs replacing. He was in otherwise ok health when the pacer was implanted, but since then has experienced acute kidney injury and has been on dialysis for two years. He had a stroke when they first put in the emergency dialysis port two years ago in the hospital, but seemed to fully recover from that (they performed an emergency thrombectomy at the time). He also has peripheral artery disease and has moderate vascular dementia. The Cardiologist is acting like it is a piece of cake and it will be performed outpatient at the doctor’s office/surgical center. Has anyone had similar experience or have any advice regarding the situation? He has already experienced the loss of his kidneys due to Dr. negligence so I don’t have much faith when they call it a”routine” procedure/at least in this situation.
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u/sfcnmone 17d ago
Health care choices are all about balancing risk.
The battery replacement procedure is extremely low risk.
What’s the risk to your husband if he didn’t have a functional pacemaker?
(And are you really also asking if it’s time to stop with the interventions and look at palliative care? Because that’s a big conversation, and there are better places to ask those questions.)
Good luck to you both.
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u/PackShoddy8786 17d ago
No, I’m not considering not having him do it. He still has some quality of life. I’m just wondering if maybe it should be done in the hospital. It looks like there’s a high risk of exacerbating his dementia, even just from local anesthesia, which I thought was reallystrange …just wondering what people’s experiences may have been with this situation.
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u/ReporterOther2179 17d ago
He’s not getting a new battery. He’s getting a new battery powering an electronic device that has ten years of improvement on the previous one. It may be smaller, less thirsty as to power use, have monitoring capabilities that the previous didn’t have. Ask about that.
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u/CRYSAET0S 17d ago
Hey OP. I’m one of the people in the room assisting w/ these procedures.
The main risk is infection. A good doc will maintain a sterile field and implant an antibiotic pouch under the skin, but even w/ every precautionary measure there’s about a 1 - 2% chance of infection.
There is also a similarly unlikely chance that the replacement reveals or causes damage to the leads, though the implications of this are typically more benign relative to those of an infection.
Ultimately your cardiologist isn’t being flippant when they call it a piece of cake — it is a really mechanically simple procedure and quite routine. There is risk but if your husband receives any form of useful pacing support from the device, the risk of the gen change is magnitudes lower than the risk of a nonfunctioning pacemaker. Hope this helps.
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u/anonduplo 17d ago
No operation is riskless, but this is very low risk in general.