Generator Change

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A Pacemaker/Implantable Cardioverter Defibrillator (ICD) revision or ICD generator change is a surgical procedure performed to replace the battery (generator) of a pacemaker or ICD when it becomes depleted, or to correct any issues with the device or its leads. 

Pacemakers and ICDs are small, battery-operated devices implanted under the skin near the heart to monitor and regulate abnormal heart rhythms. Dual-chamber (DDD) pacemakers are a specific type of pacemaker that control the timing and sequence of the heart’s two upper and two lower chambers to ensure they are working together effectively.

Over time, the battery life of these devices diminishes and requires replacement – typically every 5 to 15 years, depending on the device and how often it is used. Additionally, leads may need to be adjusted, replaced, or removed due to breakage, dislodgement, or infection.

The procedure is performed under local anesthesia with mild sedation. The surgeon makes a small incision over the site of the existing device. The old generator is disconnected from the leads and removed, and a new generator is connected and placed back into the pocket under the skin. If a lead needs to be replaced, the old lead might be removed, and a new one is threaded through the blood vessels to the heart. 

After the procedure, the patient may need to stay in the hospital for a day or so for monitoring. Regular follow-up appointments will be necessary to ensure the device’s function and make any necessary adjustments.

While generally considered safe, the procedure does carry potential risks, including infection, bleeding, bruising, damage to blood vessels or nerves, and rarely, puncture of the heart.

As with any medical procedure, it’s essential for patients to discuss the benefits and potential risks with their healthcare provider before proceeding. The decision to have a Pacemaker/ICD revision or ICD generator change depends on the patient’s overall health, the type of device, the condition of the leads, and the specific heart condition being treated.