When should a pacemaker be replaced?

A pacemaker should be replaced when the device's voltage reaches the replace rate threshold (RRT). This threshold indicates that the battery is nearing depletion and that the device may no longer be able to deliver the necessary electrical impulses to the heart efficiently. Monitoring the voltage levels of a pacemaker is crucial, as timely replacement ensures the continued proper function of the device, preventing potential complications associated with battery failure, such as loss of pacing support.

While symptoms experienced by a patient can potentially indicate the need for reevaluation of the pacemaker's function or condition, they are not the definitive indication for replacement. The same applies to lead failure; although these conditions may lead to complications requiring intervention, the specific metric guiding a change in the pacemaker itself is the voltage reaching the RRT. The arbitrary timeframe of five years does not take into account numerous factors such as battery usage, device settings, and patient activity levels, making it an unreliable indicator for replacement.