Understanding Replacement of an Implantable Heart Device
Implantable heart devices help control the heart’s rhythm. Types include pacemakers and ICDs (implantable cardioverter defibrillators). You have one of these devices. A procedure to implant (place) the device in your body was done in the past. Wires (leads) were also placed to connect the device to your heart muscle. You now need a procedure to replace the device. This is most often done as an outpatient procedure and you go home the same day.
Why do I need my implantable heart device replaced?
An implantable device runs on a battery. This battery lasts for years. A battery meter lets your healthcare provider know when the battery is getting low on energy. When it has only a few months of energy left, replacement is recommended. This involves replacing the entire device. If the battery reaches the end of its life, the device may not work properly or may revert to a low energy mode. A device may have to be replaced sooner if it stops working correctly because of infection or another problem.
What happens during the procedure to replace my implantable heart device?
The replacement procedure is often shorter and simpler than the first implantation. In many cases, only the generator needs to be replaced. The leads that connect the generator to your heart are often reused.
During the procedure:
The skin over the device is sterilized with cleaning solution and draped.
The doctor makes a new incision over the old incision.
The doctor lifts out the device.
The doctor checks the leads to make sure they work properly.
The doctor detaches the old device from the leads.
The doctor attaches the new device to the leads. This is tested to make sure it works correctly.
The doctor puts the device back under the skin.
The incision is closed.
The doctor programs the device’s settings to properly help your heart.
What are the risks of replacing an implantable heart device?
The most common serious risk of this procedure is infection. Other risks include bleeding, severe bruising, or swelling at the incision site.
March 16, 2019
Ellenbogen KA, et al. Guide to Replacement of Cardiac Implantable Pulse Generators. Boston Scientific. 358331-002. 2014. p. 36., Ganz L, et al. Cardiac implantable electronic devices: Patient follow-up. Up To Date. October 26 ed: Up To Date; 2015. p. 10., Ganz L. Implantable cardioverter-defibrillators: Complications. Up To Date: Up To Date; 2015. p. 20., Hoff RMV, et al. Implantable Cardioverter-Defibrillator and Pacemaker Infections. Hospital Medicine Clinics. 2015 April 1;4(2):150-62., Kowalski M, et al M. Problems with Implantable Cardiac Device Therapy. Cardiology Clinics. 2008 August 1;26(3):441-58.
Steven Kang MD