Signs a pacemaker needs adjustment

Woman holds a heart.

Pacemakers are critical to regulating heartbeats in people with arrhythmias—so it’s important the devices work as designed. When they don’t, adjustments may be needed.
Fortunately, these days it’s easier than ever to monitor this lifesaving technology, says Dr. Michael Malinics, a cardiologist at Tidelands Health Heart and Vascular Specialists.
The first step is for patients to stay on a regular schedule of routine follow-ups, says Dr. Malinics, who specializes in pacemaker and defibrillator implantation and monitoring. Most pacemaker patients need to come in every six months, with some needing to visit only once per year. Patients with defibrillators should come to office every three months.
Between visits, patients’ devices are monitored remotely through telephonic transmitters, which download information from the pacemaker and transmit it to the physician’s office, explains Dr. Malinics.
“The transmitter sits on the patient’s bed stand at night and communicates with the pacemaker via radio waves,” he says. “Once the information is downloaded, it’s transmitted to us and we receive it the next morning.”

Causes for concern

Potential problems the transmitter can pick up include:

  • Heart rhythm problems in the patient
  • Low battery
  • Corrosion of leads
  • Device malfunction

“The technology allows us to pick up on these kinds of problems really early so that we can make adjustments right away,” says Dr. Malinics.
When it comes to adjusting the pacemaker, the type of adjustment depends on the patient. Variables include the patient’s heart rate and how often they’re being paced. This is because some patients use their pacemakers continuously and some intermittently.

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“Every patient is different, and the programming of the pacemaker differs according to their needs,” says Dr. Malinics.
Ultimately, the goal is that every patient is being monitored continually and followed up with periodically. If a patient isn’t under the regular care of a cardiologist, he or she may experience physical symptoms when a pacemaker fails or requires adjustment. These can include:

  • Dizziness
  • Shortness of breath
  • Loss of consciousness

Anyone with a pacemaker who is experiencing these symptoms should seek medical help right away.
“The goal is for us to pick up problems before they experience symptoms,” says Dr. Malinics. “Often a patient feels fine, but a minor adjustment needs to be made—this can prevent bigger problems down the road.”

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