Is it time to replace the battery in your pacemaker? (Cardiac Implantable Electronic Device Replacement)

Do you have a small device implanted under your skin to help keep your heart beating properly? We usually call this a pacemaker, but there are other types. So these devices also work on a battery. Just like the battery in our phone, over time this battery also loses power. Then it needs to be replaced. When you hear this, you may feel scared, "Another surgery?" But this is really nothing to be afraid of. Today we will talk about everything in a very simple way, in a way that you can understand.

What does it mean to replace a heart device?

Simply put, this is a minor surgery to replace the electronic device (Cardiac Implantable Electronic Device - CIED) that helps control your heart's rhythm with a new one. There are two main types of these devices:

1. Pacemaker: Helps maintain the proper rhythm of the heart when it is beating irregularly.

2. ICD (Implantable Cardioverter Defibrillator): When the heart rate becomes dangerously fast, it detects it and delivers a small electrical shock to the heart, helping to bring it back to normal.

This surgery often involves replacing only the battery part of the device. So, it's usually not a major surgery. You often don't even need to stay in the hospital. You can be admitted in the morning, have the surgery, and go home in the evening.

Who needs this surgery?

The main reason to replace this device is a weak battery. But there could be several other reasons as well. Let's take a closer look at them.

What preparation is needed before surgery?

Your doctor will give you all the instructions you need before the surgery. This is usually what happens:

• Medication Awareness: You may be asked to stop taking some medications, especially blood thinners like aspirin, a few days before surgery. Be sure to tell your doctor about all medications you are taking.
• Testing: You will be given several tests to see if you are suitable for surgery.
• EKG (Electrocardiogram): View the electrical activity of the heart.
• Echocardiogram: A video of the heart's function and its pumping ability.
• Blood tests: Check the general health of your body.

The surgery is very simple.

As we mentioned earlier, most of the time, this involves replacing only the battery part (the generator). The wires (leads) connected to the heart are usually not touched. So this is a minor procedure rather than a major surgery.

Think of it like changing the batteries in our flashlight. But this is done very carefully, inside an operating room.

Here are the steps in the process:

1. Sedation: First, you will be given a mild sedative through a vein (IV sedation). So you will not feel any pain, and you will be relaxed, perhaps even asleep.

2. A small incision: A small incision is made in the skin where the device will be inserted. This incision is often made over the same area where the previous surgery was performed.

3. Removing the old one: The doctor then carefully disconnects the old generator from the wires leading to the heart and removes it.

4. Installing the new one: Take the newest generator and connect it to those wires.

5. Stitching the incision: After the new device is placed under the skin, the incision is closed with either a dissolvable suture or a special type of glue.

Let's also learn about the Leadless Pacemaker.

Now there's a new type of pacemaker that's very small and wire-free. It's implanted directly into the heart. If you have one like this, the process of replacing it is a little different. You might have the old one left in place and a new one put in, or you might have a small tube (catheter) put in a vein in your leg, take the old one out, and put in a new one.

What are the benefits and risks of surgery?

As with any medical procedure, there are benefits and very minor risks.

How is the recovery time after surgery?

You will recover faster than you can imagine.

• Day One: Rest a little on the day of surgery.
• First week: Avoid heavy lifting and activities that cause arm fatigue (for example, lifting objects with your hands on the side where the device is installed) for a few days.
• Pain and swelling: There may be some swelling and soreness around the incision for a few days. This is normal. The doctor will give you the necessary medication for this.

Your doctor will give you clear instructions on these things when you go home:

• How to keep the incision clean and how to care for it until it heals.
• Things to consider when buying a new device.
• When can you resume your normal activities?

Watch out for these signs: When to call the doctor

If you have any problems after surgery, it is important to recognize them quickly. Watch for the following symptoms. If you have any of these, call your doctor immediately.