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Dr Amanda Varnava: Pacemaker battery replacement

April 12, 2013
Cardiac pacemakers, small devices implanted just under the collar bone, provide electrical signals to maintain a steady heartbeat. They improve the quality of life of thousands of people in the UK and save life in some cases. Once implanted, you don’t know a cardiac pacemaker is there but you do need regular once-a-year checks to make sure they are still working well and that the pacemaker battery is well charged. “After seven or eight years, the battery in a pacemaker starts to run down and then needs checking every three months or so. Eventually, a small surgical procedure is required to replace the pacemaker box with a new one” explains Dr Amanda Varnava, Consultant Cardiologist at The Physicians’ Clinic. Last month, the Vatican confirmed that the Pope Emeritus, Pope Benedict, had this done three months before he announced his decision to step down. Dr Varnava provided an expert comment for The Mirror, explaining that problems can occur during the normally routine procedure to replace the pacemaker battery unit. On April 11th, The Telegraph suggested that since then, the health of 85-year-old Pope Emeritus Benedict has declined significantly. “Sometimes it becomes apparent during the replacement procedure that one or more of the leads that connect the cardiac pacemaker unit to the heart have failed. In this case, they also need to be replaced, which takes longer. Pacemaker implantation and replacement due to failed batteries are both done under local anaesthetic but with quite significant sedation and the procedure plus recovery time is usually between two and four hours. In patients who are elderly and also frail, this can cause them to feel tired for several days afterwards” says Dr Varnava. Following a cardiac pacemaker battery replacement, you need to follow the instructions from your care team about taking care of the wound on your chest, and on your arm, if the team needed to replace the leads. Any signs of infection (redness, swelling, feeling feverish) and you should call the number you have been given. “It is normal for the pacemaker to need adjustment after replacement of the battery unit and this is normally done at a follow-up appointment about a week after the procedure” explains Dr Varnava. Dr Varnava offers consultations to patients with symptoms of dizzyness, fainting or palpitations to evaluate them and to find out if they need any specific treatments, such as cardiac pacemaker implantation.

Cardiac pacemaker implantation and battery replacement

  • The heart beats regularly because of electrical signals that originate in the right atrium and then pass through the heart muscle. The source of these signals is the sinoatrial node, or sinus node, which is the heart’s own natural pacemaker.
  • If you develop problems that prevent efficient conduction of these signals, or your heart starts to beat too fast, or if you develop heart failure and your heart chambers don’t pump in the right sequence, a pacemaker can help.
  • An artificial pacemaker is a small electrical pulse generate that is implanted just under the collarbone. Different pacemakers have one, two or three leads that carry the electrical impulses generated by the pacemaker directly into the heart muscle.
  • When a pacemaker battery fails, the box unit is exchanged for a new one but the process is usually shorter and easier than the initial implantation, as the new unit is attached to the leads that are already in place. However, if the leads/wires are also found to be faulty, these may also need replacing, resulting in a more lengthy procedure.
  • The photograph below shows an X-ray of a cardiac pacemaker in place. The unit and its three leads are clearly visible. The red arrow highlights the coronary sinus lead, the dotted black arrow points to the right ventricular lead and the solid black arrow denotes the right atrial lead. The shadow of the heart appears within the three arrows.

Cardiac pacemaker battery unit and leads

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