Pacemaker Battery Replacement: Signs of Low Battery

Why You Need a Whole New Pacemaker When a Battery Is Low

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Pacemaker batteries generally need replacement after five to 10 years along with the unit they are housed in. While the failure rate of pacemaker batteries is low, early failure can occur and cause warning signs like skipped heartbeats, slowed heart rate, or fainting. If not replaced when indicated, a pacemaker can fail and lead to serious harm like blood clots and cardiac arrest.

This article explains what pacemakers do, when the batteries need to be replaced, and the medical signs of a failing pacemaker.

Doctor holding a pacemaker
Peter Dazeley / The Image Bank / Getty Images

Why Pacemakers Are Replaced

Pacemakers are electronic devices implanted in the human body. The environment inside the body is generally hostile to electronics, exposing them to warmth and body fluids that would easily damage cell phones or laptops.

To ensure that pacemakers the durable and effective in this environment, they are hermetically sealed to keep moisture out. They are also constructed to withstand changes in external and internal (body) temperatures.

The fact that the devices are sealed means that the batteries cannot be removed. Instead, the entire pacemaker is removed and replaced with a new unit. Depending on the device and other factors (such as wear and tear), the lifespan of a pacemaker is between five and 10 years.

The current batteries used in pacemakers are manufactured to a high standard. The premature failure rate of pacemakers is extremely low, generally under 1% after five years of use.

There are currently no pacemakers with removable or rechargeable batteries.

Why Rechargeable Batteries Don't Work

Rechargeable batteries with wireless chargers were once used in some pacemaker models but were eventually discontinued. The batteries needed recharging for several hours every few days, which not only became burdensome but caused medical problems if the user didn't keep to the recharging schedule.

The service life of rechargeable batterie was also short, around two years, meaning that implantation surgery would be needed more often rather than less.

How to Know Your Pacemaker Battery Is Low

Your cardiologist can check your pacemaker's battery function during your regular appointments. They can also monitor the device remotely through a phone transmitter or the internet.

Usually, the device provides warning signals several months before the battery runs out. Some models beep when the battery is low.

These warnings can give you and your healthcare provider plenty of time to schedule the surgical replacement of your pacemaker well before there is a risk of failure.

Surgery to Replace a Pacemaker with a Low Battery

The surgery to replace a pacemaker is usually less complex than the original implantation. This is because the old leads connected to the heart are left in place while the functional device, called the pulse generator, is removed along with the self-contained battery.

Pacemaker replacement is usually performed as an outpatient procedure under local anesthesia (which numbs the surgical site) or general anesthesia (which puts you to sleep). It typically takes two hours to complete.

Procedures can vary, but they tend to follow the same basic steps:

  1. You are attached to several probes that can monitor your blood pressure, heart rate, and blood oxygen.
  2. You are given the appropriate anesthesia. Local anesthesia is given by injection around the surgical site. General anesthesia is delivered into a vein through an intravenous (IV) line.
  3. After cleaning the surgical site with an antiseptic, the surgeon will make an incision near the edge of the generator to create a pocket, usually just below the collarbone.
  4. The surgeon disconnects the old generator from the leads and removes it from the body.
  5. A new generator is installed in the pocket, and the leads are reattached.
  6. The surgical team checks that the new device is operational and connects remotely to external monitors.
  7. The surgeon finally closes the incision (typically with dissolvable stitches) and bandages the wound.

You are then wheeled to a recovery room and monitored until the effects of the anesthesia have worn off.

You will then be asked to return for a follow-up visit. If non-dissolvable stitches are used, they will need to be removed in seven to 10 days.

Signs of Pacemaker Failure

A low battery usually doesn't lead to complete pacemaker failure, but it can cause it to malfunction (usually by disrupting the timing mechanism of the device). This can make your heart beat irregularly, too quickly, or too slowly.

A 2020 study published in BMC Cardiovascular Disorders reported that 31% of pacemaker users experienced symptoms when a battery needed replacement.

In the unlikely event a pacemaker fails, it needs to be treated immediately, If not, the results can be devastating, leading to atrial defibrillation (rapid, irregular heartbeat), coronary thrombosis (a blood clot in a heart artery), myocardial infarction (heart attack), and cardiac arrest (when your heart stops beating).

Call 911 if you experience signs of a failing pacemaker including:

  • Sudden lightheadedness or fainting
  • Chest pain with weakness, dizziness, nausea, or vomiting
  • Trouble breathing
  • Heart palpitations (skipped heartbeats)
  • Sudden slower or faster heartbeats
  • Constant twitching of chest or abdominal muscles

A low battery is only one cause of pacemaker failure. Others include loose leads, a change in your heart condition, or an electromagnetic pulse from a power generator.


Pacemaker batteries have an average lifespan of five to 10 years. When battery levels are low, the entire device (less the power leads) needs to be surgically removed and replaced.

Your cardiologist will check the battery level of your pacemaker with every visit. There are usually built-in warnings to advise you when the battery levels are low.

Pacemaker replacement surgery is usually performed on an outpatient basis with either local or general anesthesia. The timely replacement of a pacemaker is important as the failure of the device can lead to potentially serious harm in some, including death.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Liu J, Wen L, Yao S, Zheng P, Zhao S, Yang J. Adverse clinical events caused by pacemaker battery depletion: two case reports. BMC Cardiovascular Disorders. 2020;20(1). doi:10.1186/s12872-020-01622-x

  2. Gignolani E, Goldhaber JI, Marban E. Next-generation pacemakers: from small devices to biological pacemakers. Nat Rev Cardiol. 2018 Mar;15(3):139–50. doi:10.1038/nrcardio.2017.165

  3. Rajaeeefard A, Ghorbani M, Baigi MAB, Tabatabae H. Ten-year survival and its associated factors in the patients undergoing pacemaker implantation in hospitals affiliated to Shiraz University of Medical Sciences during 2002 - 2012. Iran Red Crescent Med J. 2015 Nov;17(11):e20744. doi:10.5812/ircmj.20744

  4. Malllela VS, Ilankumaran V, Rao NS. Trends in cardiac pacemaker batteries. Indian Pacing Electrophysiol J. 2004 Oct 1;4(4):201-12.

  5. Takeuchi T, Yui H, Yui C, et al. Reimplantation of a pacemaker into a subpectoral pocket via the lateral approach in collaboration with plastic surgeons. Intern Med. 2020 Apr 1;59(7):967–70. doi:10.2169/internalmedicine.3979-19

Additional Reading
  • Tracy CM, Epstein AE, Darbar D, et al. 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-based Therapy of Cardiac Rhythm Abnormalities: a Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation 2012; 126:1784.

By Richard N. Fogoros, MD
Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.