Is Getting Your Pacemaker Replaced a Big Deal?

Many patients understandably worry about this question when told they’ll need a pacemaker replacement. The short answer is that replacing your pacemaker is typically not a significant issue, especially compared to the initial implantation. However, like any procedure, it’s important to understand what it involves and how to prepare for it.

Why Would a Pacemaker Need to Be Replaced?

Pacemakers are designed to last for many years—typically 6 to 12 years, depending on the type of device and its usage needs. Over time, the battery (known as the pulse generator) discharges, and even rechargeable batteries eventually wear out. When this happens, the device doesn’t stop working suddenly; your doctor will monitor it through regular checkups and anticipate when replacement is needed well before the battery is fully depleted.

Notably, most replacements involve only the battery and the pulse generator, not the wires (called leads) that connect the device to your heart. If the leads function well, they are left in place, making the procedure significantly more straightforward than the original implantation.

Note that some modern pacemakers are leadless to reduce complications associated with lead degeneration, migration, or breakage. Typically, the implantation of a replacement device leaves the initial device deactivated within the heart. Sometimes, the original device will be removed if it poses an ongoing concern.

What’s the Procedure Like?

Pacemaker replacement is generally less invasive and quicker than the original implant. It’s typically done on an outpatient basis under local anesthesia and light sedation, meaning you’re awake but relaxed. The physician reopens the original incision, removes the old generator, and connects the new one to the existing leads. The incision is then closed, usually with dissolvable stitches.

For leadless pacemakers, a small catheter is threaded from the groin or wrist to the appropriate heart chamber. The new pacemaker is deployed through this catheter, attached to the wall of the chamber, activated, and programmed. The old pacemaker is deactivated. This is usually performed under sedation in an electrophysiology, or EP, lab.

Most patients are discharged the same day and can resume light activities shortly after. Full recovery is expected within one week. Your doctor may advise avoiding heavy lifting or strenuous upper-body movements for several days.

Is It Risky?

While all procedures carry some risk, complications from pacemaker replacement are rare. The most common concerns – infection, bleeding, or lead damage – are closely monitored. Because the procedure and placement are familiar to the team, the risk is often lower than during the initial implantation. That said, health status, age, and underlying conditions can affect the approach to the procedure. Your electrophysiologist will evaluate this and ensure the procedure is safe and the technique appropriate.

The Bottom Line

In most cases, replacing a pacemaker is a routine, low-risk procedure that can be completed in under an hour. It doesn’t require major surgery or an extended hospital stay. Most importantly, it allows your pacemaker to support your heart safely and effectively long into the future.

Don’t be alarmed if you’ve been told you need a pacemaker replacement. Good planning and follow-up make the process smooth, and recovery is quick. Always consult with your electrophysiologist or cardiologist to discuss what to expect and how to prepare so that you can feel confident every step of the way.

Dr. Tordini is a part of Florida Medical Clinic Orlando Health