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What to expect when my mother's pacemaker battery runs out?

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General & Family Physician
Practicing since : 2009
Answered : 9400 Questions
I'd like to know what to expect when my mother's pacemaker battery runs out. She does not want it replaced. She is 77 yo. Obese, diabetic, COPD, and has several back problems that she has been told are non-operatable due to her poor health. She is in constant pain. She is rapidly approaching the inability to perform daily functions for herself - shopping, laundry, We saw her cardiologist yesterday and he says she is PM dependent, but that her heart is functioning just fine. It was originally placed for a low heart beat and an Afib. Her cardiologist stated that the end of life could not be predicted and could range from falling asleep and going peacefully to her heart stopping then starting on it's own again after 1 minute or more causing a slow decline in brain function. My question is - what would be the expected time frame for the slow decline - where her heart would stop and start on it's own. Would we be talking days, weeks, months, or years? Even with the info her cardiologist gave us, she is still not wanting to get the battery replaced and I am the one who will be taking care of her through this process. I need to know what will happen.
Posted Tue, 4 Mar 2014 in Heart Rate and Rhythm Disorders
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: All queries answered & my prayers for you both Detailed Answer: Hello sir/ma'am and welcome. Thank you for writing to us. I understand your concern, and am sorry you have to experience this. But at times, our elders make a few decisions that don't make sense to us. But then again, we are not going through all that they are and have not experienced all that they have, so we are sadly in no position to question them. My prayers are with you and your mother. May god bless you both with his abundance. As for your queries; if your mother is entirely dependent on the pacemaker then once the battery is about to die, your mother's heart will not be able to function on its own, which will result in the heart rate dropping which will present in the form of slow loss of consciousness (within a matter of minutes, rarely hours). And once the loss of consciousness has taken place, death usually follows within a few minutes from that. Your doctor has described this in the form of death while she is asleep or the heart trying to beat on its own a while later, but then again it most probably wont (if it is completely dependent on the PM) and even if it does, it will stop a while later. But just so you know, no pain will be experienced at all. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help. Best wishes and God Bless.
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Follow-up: What to expect when my mother's pacemaker battery runs out? 1 hour later
Thank you for your kind wishes and prayers. I appreciate the information you've given me. I am encouraging mom to have a second consult with her cardiologist and, if needed, a second opinion as well. What are some specific questions I could ask in these consultations that would help us better understand what is most likely to happen for her? For example - when a person is deemed PM dependent - is that a 100% situation or is it possible to be 50%, 60%, 70% dependent? If so would that alter the expected outcome you've described? What other facts should I be asking about before her battery runs out? Bottom line is that she does not want to die little by little over months.
Answered by Dr. Shoaib Khan 35 minutes later
Brief Answer: All queries addressed sir/ma'am Detailed Answer: Hello once again sir/ma'am. I understand and respect your mother's decision, but then again, as a daughter/son this must be difficult to accept for you. I am sorry about this, and may god XXXXXXX you the strength to deal with this. The questions are all very basic, as the information is very limited. First of all, the dependence is given a percentage. It can be 100 %, or lesser. Yes, the scenario can change a little bit, with the varying percentage. With a 90 % and above percentage, we can expect the patient to slowly lose consciousness and pass away. Whereas, in percentages lesser than those we can expect the individuals heart to try to pump on its own, and fail after a few attempt or not try at all or even try and succeed for a while. So you can ask her doctor about the percentage of dependence, and what we can expect once her PM battery dies. Also, make sure you ask him/her about the duration within which we can expect her to lose consciousness, and how long she will live after losing consciousness. Whether we can expect death soon after, or will she live on. And if she lives on, will she regain consciousness or not. All questions that revolve around her comfort and life expectancy need to be cleared with her doctor. I wish her nothing but the best and hope god grants her only what is best for her. Please do not hesitate to write back to me for any further clarifications, I am always available to help. Best wishes.
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