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Is undergoing a pacemaker battery replacement procedure safe for a diabetic?

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Posted on Thu, 8 Jun 2017
Question: My ejection factor is 20 to 30 percent. My pacemaker battery needs replacement at considerable cost.
What are my options? I am 90, diabetic 2, watchful waiting prostate cancer, stage 3 kidney disease,
pacemaker and defibrilatter after triple by-pass. Working (self-employed) full time, providing 24/7
critical materials to utilities, government, and industry.(Very challenging! Formerly practiced law
after 8 years of night school and the service. Should I risk the battery procedure? Any options?


Advised to replace battery of implanted pace-maker implanted 2011
. Ejection factor 20 to 30%

Concerned about high infection risk factor. Scrubbing up, changing bedding,
fresh clothes, great cost
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your question and would explain that your actual health conditions need several special considerations.

First of all, as you have a high burden of co-morbidities (heart failure, diabetes, prostate cancer, chronic kidney disease) it is important to maintain a careful balance of your cardiovascular system, paying special attention to heart failure treatment.

A continuous optimization of heart failure therapy means that almost half of the good work is done. Your several health disorders may act as dangerous triggering factor and exacerbate heart failure deterioration leading to life-threatening conditions and repeated hospitalizations.

And believe me that costs of the above complications management easily exceed what could be imagined from a simple pacemaker battery replacement.

It is true that invasive procedures (such as battery replacement) may be associated with a relative risk of infection and deserve temporary special care, but from the other side, if you are completely pacemaker dependent all the time (your pacemaker keeps maintaining your heart rate/rhythm almost for 24 hours daily), then you need to seriously consider pacemaker battery replacement in a timely fashion if the battery is near end of life.

The best option in your case, considering your ischemic cardiomyopathy with a low LVEF (20%-30%) would be a possible re-synchronization therapy coupled with optimization of your heart failure medications.

This could increase your cardiovascular performance and subsequently improve your daily physical activity; helping also the management of co-morbidities (diabetes and kidney disease).

I would strongly encourage you to consider all the available possibilities at your reference hospital in regard of primarily maintaining an optimal management of your heart failure conditions as it would be the key of favorably dealing with the other co-morbidities.

In case you provide me with concrete medical reports (including cardiac tests, such as cardiac ultrasound, Rhythm monitoring, EP reports, current therapies, etc.), I could give a more specific professional opinion.

Hope to have been helpful to you!

In case of any further questions feel free to ask me again.

Kind regards,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 4681 Questions

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Is undergoing a pacemaker battery replacement procedure safe for a diabetic?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome on HCM! I passed carefully through your question and would explain that your actual health conditions need several special considerations. First of all, as you have a high burden of co-morbidities (heart failure, diabetes, prostate cancer, chronic kidney disease) it is important to maintain a careful balance of your cardiovascular system, paying special attention to heart failure treatment. A continuous optimization of heart failure therapy means that almost half of the good work is done. Your several health disorders may act as dangerous triggering factor and exacerbate heart failure deterioration leading to life-threatening conditions and repeated hospitalizations. And believe me that costs of the above complications management easily exceed what could be imagined from a simple pacemaker battery replacement. It is true that invasive procedures (such as battery replacement) may be associated with a relative risk of infection and deserve temporary special care, but from the other side, if you are completely pacemaker dependent all the time (your pacemaker keeps maintaining your heart rate/rhythm almost for 24 hours daily), then you need to seriously consider pacemaker battery replacement in a timely fashion if the battery is near end of life. The best option in your case, considering your ischemic cardiomyopathy with a low LVEF (20%-30%) would be a possible re-synchronization therapy coupled with optimization of your heart failure medications. This could increase your cardiovascular performance and subsequently improve your daily physical activity; helping also the management of co-morbidities (diabetes and kidney disease). I would strongly encourage you to consider all the available possibilities at your reference hospital in regard of primarily maintaining an optimal management of your heart failure conditions as it would be the key of favorably dealing with the other co-morbidities. In case you provide me with concrete medical reports (including cardiac tests, such as cardiac ultrasound, Rhythm monitoring, EP reports, current therapies, etc.), I could give a more specific professional opinion. Hope to have been helpful to you! In case of any further questions feel free to ask me again. Kind regards, Dr. Iliri