Pacemaker removal

[tracie4444]

I was wondering what percentage of people can actually have their pacemaker removed if it is determined that the patient no longer needs it.  Can a pacemaker ever be removed?  

[ireneo]

I don't know the percentage.  I can see the unit itself being removed since that's how they "change the battery." But the leads into the heart, once they've grown over with heart tissue, I don't see how they could be removed.

[banglamom]

If a person doesn't need the pacer any more, they don't remove the leads without a very good reason as it is a much bigger surgery than putting them in in the first place.  I have seen xrays of transplants... and wires were just cut and the unneeded pacer left in place.  Cracked wires sometimes have to be replaced but it is a major event.  If there is an infected pacemaker pocket, the wires sometimes have to be changed to prevent infecting the heart.  When a pacer goes in, it isn't with the intention of removing it.

[Wisconsin2007]

That's odd - I thought I'd read of at least one member here having a ICD implanted because of arrhythmias, and after four ablations his heart was doing well, so they removed it.  Unless  a pacer and an ICD are different animals, but I thought they were more or less the same, just with some different programming and slightly differing abilities.

[BLM_56]

Pacers (pacemakers in the vernacular) and ICDs are, indeed two completely different devices with totally different functions.  While both have a battery and a microcomputer these days, that is where the similarity ends.

An ICD is an Implanted Cardiac Defibrillator.  It is used when a person has a tendency to go into or approach V-fib.  The device monitors the heart rate and waveforms and when those match pre-programmed parameters it delivers a significant jolt of electricity to do the same thing as cardioversion.  Since the electricity is being applied directly to the heart muscle it takes much less energy - on the order of joules versus hundreds of joules (1 joule = 1 watt second) in an external cardioversion.

But even that is many times the amount of electrical energy a pacemaker (properly a pulse generator) delivers.  My device is currently running at 1.125 volts and is delivering a few microjoules per pulse.  It takes a lot less energy to trigger a beat than it does to stop the heart so it can reset itself.  If the person you mentioned was in a-fib and the bombardment of the AV node was causing it to go into v-tach and even fib, an ICD would be need to keep the patient alive.  If ablation (or even multiple ablations) reduced the instability in the atria then the AV would be expected to "settle down".  With the threat of v-fib removed an ICD would no longer be needed.

That being said, I do not think my EP would reove the thing.  For one thing the instability could return.  For another, no sense cutting someone open unnecessarily.  

Hope that explanation helped.

Tracie4444, even if the device would no longer be needed there would be no good reason to remove it.  If it is like mine it can be shut down from outside.  There is much more risk of problems cutting someone open - even in so minor a way as would be needed to remove the device - than just leving the thing in place and quiescent.  

[banglamom]

All pacemakers and AICDs are programmable through the chest wall with devices.  If you have an AICD though, it can be turned OFF with a magnet so be careful.  Then it can only be turned back ON with the programmer.

[Wisconsin2007]

Thanks BLM, that addresses a bit of the question, but it seems like the crux of some of the first responses is that the leads going into to the heart are the limiting factor in removal of a device, pacer or otherwise.  The person I was referring to said he was having 30,000 or so PVC's a day and getting defibrillation jolts frequently, and after ablations had the device removed.  I would imagine the leads were removed as well.

My question has less to do with the function of each device and more with whether having one device or the other would make future removal more or less difficult.  As I understand it, an ICD and a pacer (and for that matter, the ones that are dual purpose) both are small units with leads that go into the heart.  Unless there was something radically different about the implantation of an ICD versus a pacer, it would seem that if one could be removed, either could be removed, and since there's a member here that had an ICD removed, I would think a pacer could be, too (provided of course that the cardiologist agreed).

[PikaPika88]

Isn't the doctor written down PPM (permanent pacemaker)?  What is the different with just pacemaker and permanent pacemaker then?  

I think now a day some types of pacemaker also can pace out the abnormal rhythm before it reaches to the ventricle.  Like my A-Fib and A-Tachy, it will reach directly to my ventricle without passing a traffic light.  

[BLM_56]

You're welcome.  The device itself is simple to remove.  It sits in a pocket just under the skin below the collarbone.  Absent a terribly compelling reason I would never want to contemplate removing the lead(s).  The lead is threaded down through the vena cava and into the heart.  Over time the heart muscle actually grows around the lead so simply pulling it out (like yanking an electrical cord out of a wall socket by pulling on the cord itself) is not an option.  My understanding is that removing the lead involves open heart surgery.  

But why would someone WANT to remove the device?  If it is no longer needed the simple thing would be to just shut it down and go about one's business.  Our skin serves a very important function as the first line of defense against microbes.  Since removing the device wold involve cutting through all the layers of skin and even the capsule of scar tissue that formed around it, such a procedure would open the patient up (literally) to the possiblity of infection.  Unless the thing is causing problems where it is, the safest course would be just to leave it alone.  

Did I answer your question?

Bionic Bill

[wilmajoyce]

it should be removed as it is a forign object in the body

[tracie4444]

The reason why I raised the question is because my electrophysiologist determined I no longer needed my pacemaker and removed it in January 2009.  I started having significant episodes right after it's removal and just had it put back in March 6.  I am 39 years old and run marathons and am healthy otherwise.  I am just trying to figure out if this is common or not.  

[stosh285]

I am 64, pacemaker put in 3 weeks ago. Am tired of it and want it out. The  pain, the hideous bulge, the scar are just a few of my reasons. I didnt mind the  dizziness, or feeling faint. This wasnt my idea and want it out! I dont feel any different than I did before and  dont believe it is doing anything helpful. Dont say  to talk to my doctor, I dont like him. He talks  to me like I am a little kid. Is MY body  not anyone elses.

[wilmajoyce]

I DONT BLAME YOU.  CARDIOLOGIST TOLD ME NOTHING ABOUT SIDE EFFECTS  ABLATIONS WERE WORKING AND HEART READ FINE.  NO ONE KNEW WHAT WAS WRONG.  AMONTH LATER JOINTS SWELLED   PLAQUE PSORISIS.  SKIN PEELS OFF.  HAIR FALLS OUT....I CAN NO LONGER STAND MORE THAN 10 MINUTES WITHOUT PAIN.   SURGUR SPIKED TO 850    ER TRIPS BUT NO ONE DOES ANYTHING.   ENDOCRONOLOGIST SAID NO SUGAR PROBLEMS.  ROUMOTOLOGIST DID NOTHING EVEN THO PILES OF DEAD SKIN AT MY FEET AND SWOLLEN JOINTS.  ILL RISK DEATH AND SIGN ANYTHING TO RELEASE ANY CARDIOLOGIST TO REMOVE.  IM TORTURED EVERYDAY WHEN IM ABLE TO WAKE UP AS I NOW SLEEP UP YO TWENTY HRS A DAY.  YOURE LUCKY U DONT FEEL ANY DIFFERENT THAN BEFORE.   MY LIFE IS A LIVING HELL.   GOOD LUCK TO YOU    8654554679.  PLEASE SOME CARDIOLOGIST CALL ME IF U CAN REMOVE THIS THING EVEN IF JUST THE BOX.  ILL NEVER LET IT BE USED NOT LET ANYONE ADD BATTERIES.   TITANIUM ….HELL NO MORE   IVE PRAYED TO DIE THO IM NOT SUICIDAL.   THIS IS NO LIFE    GOD KNOWS I DONT WANT TO EXTEND IT    NOT LIKE THIS.  CARDIOLOGIST DAID NO SUCH THING AS IMMUNE SYSTEM ATTACKING HEART.  YEAH...RIGHT.  IVE LIVED LIKE THIS 3 YEARS.  GOD LET ME DIE

[MichelleP_3811]

I am sorry to hear about your frustrations.  I don't really know what to say about your pacemaker since I don't have much experience with them but have you thought about finding a new cardiologist?  You do not deserve to be talked to like a child.  There are a lot of nice ones out there I hope you find one that suits your needs.  I hope things get better for you.

[Mom2four85]

sounds like it's time for a new doctor if you can find one that suits you; I've found most doctor's are like this especially the higher educated ones for some reason - just my opinion of the 17 cardiologists and EP's I've been through in 2 years but others may be able to give you a referral to another doctor

I know about dizziness and fainting and sympathize with you on that...I've hit my head so many times they think when I fainted this past June hitting the tiled side of my tub was 1 more time than it should have been

my CT shows some changes that are consistent with mild brain damage along with my neurological changes that has happened with too many falls; luckily for me I only severely sprained my neck and didn't break it completely so a brace for a few months helped it heal.

I know what you mean about no choice...I had an abltion and I had a DNR (do not resucisitate) order.  During the procedure I felt my heart burst; my heart stopped, I yelled STOP! and tried to sit up to make them stop but they wouldn't.

FL law says no matter what DNR I have; I signed a paper for the dr right as I went into the OR that said he HAD to save me if anything happened

I didn't read the fine print but obviously I'm here for some reason  - For me, I think my device is the lesser of the two evils...

[taniaandclyde]

I have a relating question to ask! Please help us to find an answer! My husband had a pacemaker implanted on the 15th of December 2011 (6 weeks ago). The doctors made a mistake and implanted the wrong type! Now they tell us that they want to replace it. How dangerous is it? We are so afraid of it! The leads probably have already grown into his heart tissue...
please e-mail the comments to ***@****!

[kthomas2038]

I had a pacemaker implant October 4 2010. I am 54 years old now and it seems it really is not helping much anyways. My heart rate seems to still be all over the place . And I really felt the hospital and doctors did not give me any choice about getting the implant in the first place. It is uncomfortable to sleep with and the bulge and the scar really irritate me.After hearing the stories on here about having it taken out really does not sound any more appealing to me than keeping it in.

[sgglieb]

I has a pacemaker put in 4 years ago, I was in the hospital with severe dehydration and Dr cmes and says your heat rate is between 25-35BPM my response was so, he said it was dnagerous I replied well I don't feel bad, never had chest pains, light headness, fainting or even blood pressure issues. Over the next two days as my fluids were replaced and I was more active the Dr came back and said the ame thing telling me if I do not get a pacemaker he will release against medical advice. In todays insurance world I would havehad to pay my entire bill as the insurance company told me if I do not follow Dr's orders they do not pay. So I agreed and have regretted ever since. My left shoulder hurts all the time, I can't sleep or lay on left side, pacemaker sticks out and is very noticeable, and the worst was trying to get thru TSA without taking my shirt off even with all the correct documentation for a implanted pacemeker. Tomorrow I go to Dr and am telling to remove pacemaker not just turn it off, also found that I have been charged $80 a month for ST Judes Merlin monitor that sends data from pacemaker to Dr once every 4 weeks, what a rip-off.

[SimonJenkins]

Batteries are not changed, pacemakers are sealed units, the whole old pacemaker is removed and replaced with a new one

[Cookie___]

Pacemakers can be removed as I'm having one removed myself
Hope this helped :)

[Artaud]

On the topic, they now have leadless Fully Retrievable Pacemakers. The entire device is implanted in the heart, apparently at this time approved for Bradycardia.

http://www.mountsinai.org/about-us/newsroom/press-releases/first-leadless-pacemaker-in-united-states-implanted-into-a-patient-at-the-mount-sinai-hospital

[mariop]

In jan 2008 I had my ICD removed.  The Cleveland Clinic has a Doctor (Wilkoff I think is the name) that specializes in removal of PM/ICDs.  At that time Highmark covered everything.  The ICD was pulsing my phrenic nerve.  The local doctors told me it was in my head and not in my chest.  At Clev Clinic they said the problem was the ICD device.  My suggestion to you is to go to another doctor outside of the area where you are.

[gingerdog2]

Hi-I'm a 65 year old woman, have never fainted and they want to give me a pacemaker. I feel fine and this is totally out of the blue. The doctor is a specialist at a major hospital here in Chicago but I'm reading too many stories like yours. Did things ever get resolved for you? Thanks so much

[DeltaDawn23]

I was in the hospital with afib and my ep of 10 years was out of town.  The doctor assigned to me insisted I needed an av node ablation and a permanent pacemaker.  It had never been mentioned to me before and was not on the table with my ep.  I refused it and still they were getting ready to do it.  I went to another larger university hospital and they said, 10 years ago that's all thy could offer, but I have a 85 percent chance of getting rid of the afib with a catheter ablation and they would not recommend a pacemaker for me.  I would get another opinion.  Good luck to you.  Stick to your guns!  You should be the one making the decision -- you will be living with it, paying for it and it's up to you, not someone else, doctor or not.

[Skecjean]

I can see this post has been written over 3 years ago or so and I was wondering if you ever had your pacemaker removed. I've have had mine in now for almost 2 years. I remember thinking like you did when I first had mine. I didn't think I needed it anymore. And when they would integrate it, it seemed like the percentage of its usage was not very high, and I thought, it was not worth having it in. I think at one point my PM was only working at 3% of the time. To me that didn't warrant having it in. When I first received mine. I was dizzy all the time. My heartrate was beating at 20 BPM. So very low and my heart doctor felt it was necessary to have it put in. Since then, I feel better. I just hate the fact that now my back is hurting so bad, that I can't have an MRI to see what is wrong. So, I want my PM unit taken out just so I can have an MRI. Leaving the leads in .. but wonder if leaving the leads in would mean I couldn't have an MRI done anyway.. and since they can't be removed it seems.. I am so frustrated to think my back pain will never be diagnosed correctly ...leaving me in the most horrible pain ever..

[wilmajoyce]

SAME HERE  HORRIFIC BACK PAIN   HEART READ FINE BUT AFIB   NO ONE KNEW WHY  ABLATIONS WERE WORKING  HAVE IMPLANT  MONTH LATER INSTANT ARITHTIS  PLAQUE PSORISIS   SKIN PEELING OFF  HAIR FALLS OUT.   JOINTS ACKE EVERYWHERE   MAJOR PAIN IN 72 HOURS   CVOULDNT GET UP OR WALK....HIRED CAREGIVER 6 MONTHS PLUS.  THEN A LITTLE IMPROVMENT.   SUGAR SPIKES AND ER,   SLEEP 20 HOURS A DAY.   ITS AN IMMUNE RESPONSE THO CARDIOLOGIST WONT ADMIT ITMY LIFE IS ONGOING HELL.  NOT SUICIDAL BUT PRAY TO DIE.  WANT THING OUT.  GOD HELP ME   8654554679   NO ONE WILL REMOVE IT THO IM ONE PAYING IN PAIN  FEET HAVE NEVER GONE DOWN AND STAY PURPLE ALL TIME.  ALL SINCE IMPLANT.  I AVOID SALT   DONT LIKE IT.  BUT BEFORE FEET STAYED UNSWOLLEN MOST OF TIME.  NOT NOW

[wegobeach2]

Skecjean, my EP cardiologist plans to remove my ICD and all the leads. He told me yesterday that he does it all the time. I decided not to have it anymore. I too needed MRIs but for other reasons as well. He told me they do MRIs all the time at Beth Israel Hospital in Boston even with these devices already implanted in the patient. The MRI machine is set a certain way so that they can do it safely. I would check around. Call other cardiologists and major hospitals. Both the removal and the MRI with these devices remaining in place are being done. Good luck with it.

[sonyafly]

I want my pacemaker and leads removed!  I have been very ill since it was implanted in 2012. My heart is healthy. I NEVER use the pacemaker. Less than 1% of the time. I believe perhaps the titanium in the leads may be making me so weak and sick. I was doing well until the day this thing was put in. Ok only 40. I want my life back. Please tell me who your Dr is. I'm desperate. I'll fly wherever.

[shs03001]

I want to remove mine too

[wilmajoyce]

SAME HERE   ITS AN IMMUNE RESPONSE.   NOT SUICIDAL BUT PRAY TO DIE   SKIN PEELS OFF...JOINT PAIN EVERYWHERE PLUS IN LIMBS TOO...SLEEP 20 SOME DAYS  BACK PAIN NOW SO BAD CANT STAND MORE THAN 10 MINUTES AT A TIME.   DEVELOPED LESIONS AROUND SPINE ON BACK HIPS AND NECK.  FEET ALWAYS SWOLLEN AND PURPLE NOW   SUGAR SPIKES AND ER.   TRIPS   THEN SPECIALIST SAYS NO SUGAR PROBLEMS   SAW YOUR COMMENT   I TOO WANT MY LIFE BACK   AND WISHED I HAD A DOLLAR FOR EVERYTIME A HEART DR SAID HEART SCANNS FINE   AND DONT KNOW WHY THIS AFIB HAPPENS BUT ABLATIONS WERE WORKING.  I BEGGED HIM NOT TO IMPLANT THIS THINF  LIFE HELL  N 8654554679

[SRaj1]

Dear Wilma Joyce, I can feel your discomfort and angst. I had gone to Emory Johns Creek Atlanta for heart pain. They did a great job with the angio and showed my minor block. But they left a small blade thin half button size seal in my artery in my groin. I feel it every time I move my leg. I am so mad at them. They never mentioned it or asked my permission.

I pray you find a way to remove it. This forum is so informative.

In HIM
SRaj

[wegobeach2]

This is the surgeon who removed my defibrillator. He said he does this all the time. Mine came out easily and I am glad I had that done. The first night recovery was painful but after that things got better real fast. This is the man who took it out in Boston at Beth Israel Hospital. I hope this helps someone. Peter J. Zimetbaum, M.D., director of clinical electrophysiology at the Cardiovascular Institute (CVI) at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard Medical School, oversees this service.  Dr. Zimetbaum is a distinguished clinician, researcher and educator in the fields of EP, atrial fibrillation, cardiac intensive care and treatment of arrhythmias.  He was recently appointed Chief of Clinical Cardiology at BIDMC.

[VCJohnson]

If you are anywhere near The Cleveland Clinic, Cleveland OH, consider asking Dr. Bruce Wilkoff about removing yours.  He has done many removals, including lead extraction when necessary.