Generator Replacement

You would be very familiar with your cardiac device (pacemaker / defibrillator). Your device has two main highly sophisticated components: the lead(s) and the generator (which is also the battery unit). The battery cannot be removed from the generator or recharged. The generator unit which houses the electrical circuitry and battery will have to be replaced altogether. This also ensures that you have the most advanced technology and system helping your heart.

What are the risks of having a generator change?

They include but are not limited to the following.

Common risks and complications (more than 5%) include:

• Bruising / bleeding at the pacemaker site
• Large collection of blood (Haematoma) – this can take several weeks to settle
• Pain at the pacemaker site

Uncommon risks and complications (1- 5%) include:

• The pacemaker / device lead(s) can move. The lead will need to be put back into place by repeating this procedure
• Bad bruising if you are taking blood thinning drugs such as Warfarin, Xarelto, Eliquis, Dabigatran Aspirin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin)
• Unexpected device failure. There is a risk of battery (generator) or lead failure. This is uncommon but means the battery or lead will need to be removed and a new one put in
• Infection of the pacemaker site. This will need treatment with antibiotics and/or removal of the pacemaker
• Rarely the existing wires may have to be replaced

What happens after a generator replacement?

At the end of your procedure, a simple dressing is applied over the pacemaker site. You may have a larger dressing applying pressure at the site overnight. You’ll be watched closely in a recovery area, and depending on how you feel, you might need to rest in bed for a while. You may be admitted to the ward for observation overnight with rhythm monitoring. People are usually discharged 6 hours later or the next day after a pacemaker check.

What happens after discharge?

Wound Care:

• The dressing on your wound should be left in place for two weeks. You may shower, as it is waterproof, but you cannot submerge in a bath or pool.
• Two weeks after the operation, please see your GP to have the dressing removed.  Do not remove or change the dressing before this time.
• If the wound becomes red, hot, swollen, more painful or starts to drain fluid, see your local doctor immediately, or call the rooms on 9500-0296.

Special Issues:

• DRIVING: You may drive after one week for a pacemaker and two weeks after a defibrillator generator change. You can find out more about the driving restrictions from the Austroads website (https://austroads.com.au/drivers-and-vehicles/assessing-fitness-to-drive)
• It is normal to take Paracetamol (Panadol) regularly for the first few days at home.

Follow Up: You will be sent an appointment to see me for a pacemaker check in 2 -3 months.  Usual follow up thereafter is 6-12 monthly appointments to keep track of the device function. It is recommended that you continue your usual follow up with other treating specialists and medical practitioners involved in your care as usual. If you do not receive an appointment, please call the rooms.

Remote monitoring We can monitor the function of your pacemaker while you are at home via remote monitoring. Please refer to the remote monitoring section for more information.