Pacemaker Durability: When Does a Non-functional Pacemaker Need Removal?

The lifespan of a pacemaker, once implanted, can extend far beyond what might be expected. While some people presumptuously believe that a pacemaker can only stay in the body for a limited period after it becomes non-functional, the reality is far more nuanced. A pacemaker can remain in the body indefinitely, provided it does not present health risks or complications. This article explores the longevity of non-functional pacemakers and the circumstances under which removal might be necessary.

The Role of Continuous Functionality

Typically, pacemakers are left in place as long as they continue to function properly. However, when a pacemaker becomes non-functional, the situation changes. The necessity of removal primarily depends on the patient's current health condition, the risks associated with keeping the device, and the potential for complications if it were to be removed.

Complications and Risks

Removing a non-functional pacemaker carries its own set of risks. These include the risk of infection, bleeding, and post-surgical complications. In some cases, the electrodes and pacing wires may become embedded in scar tissue, making removal more challenging. The overall health of the patient must be assessed to determine the feasibility of removal and the associated risks.

End-of-Life Considerations

When a pacemaker is no longer functional, the primary concern is whether it is causing any health problems or discomfort. For example, if the pacemaker leads have scarred into the heart muscle, removal could pose more risks than leaving the device in place. Additionally, pacemakers are not biodegradable and will remain in the body unless removed for medical reasons.

Removal: Medical and Patient Preferences

In some cases, patients or their cardiologists may request the removal of non-functional pacemakers. This decision is often based on personal preference, although some cardiologists may comply based on the patient's request without a specific medical reason. Other factors, such as pain, skin erosion, or infection, might warrant removal. The cardiologist's assessment of the patient's overall health and the potential risks and benefits of removal will guide this decision.

Environmental and Other Considerations

While the primary concern is patient health, there are also broader considerations. For example, if the pacemaker is non-functional and the battery reaches its expiration, there is a risk of hazardous waste if the battery is not properly disposed of. Additionally, when a body is cremated, the non-functional pacemaker (specifically the lithium-ion battery) can release toxic fumes, necessitating its removal by the funeral director to ensure safe cremation.

Conclusion

In summary, a non-functional pacemaker can remain in the body indefinitely, provided it does not present any significant health risks or complications. The decision to remove it is a complex one that involves evaluating the patient's current health, the risks and benefits of removal, and other practical considerations such as environmental impact. If you or a loved one are considering pacemaker removal, it is advisable to consult with a cardiologist to make an informed decision based on individual circumstances.