How is a pacemaker implanted and how long does the battery last?

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1. 1

   Outcomes of primary leadless pacemaker implantation: A systematic review

   Annals of Noninvasive Electrocardiology (Noor et al.)Published Aug 22, 2023Checked Oct 12, 2026

   “Gonzales et al. and Marschall et al. showed the duration of the procedure to be 180 ± 45 versus 324.6 ± 92 and 39.9 ± 8.7 versus 54.9 ± 9.8, respectively. Zhang et al. demonstrated the duration of the procedure and fluoroscopy time to be 36 ± 13.4 and 11.1 ± 3.1, respectively. Similarly, Schiavone et al. exhibited intermediate times of implantation at 60 (45-80) versus 50 (40-65) and fluoroscopic times at 6.5 (5-9.7) versus 5.1 (3.1-9). Hospital stay was more with a temp-perm pacemaker as compared to LPM and pacing parameters were not significantly different in all the studies. For underlying arrhythmias, whenever appropriate, our review shows that LPMs may be a better option than temporary pacemakers, even as an urgent treatment.”

2. 2

   Leads and longevity: how long will your pacemaker last?

   EP Europace (Shepard & Ellenbogen)Published Nov 4, 2008Checked Oct 12, 2026

   “Modern pacemakers use current not only for pacing but also for other functions such as obtaining measurements of diagnostic data, measurements made by rate response sensors, and implementation of algorithms, such as for mode switching. Pacemaker battery life therefore depends on a variety of variables, including baseline battery self-discharge, current drain for device housekeeping functions, current used to pace the heart, and current to sense the underlying heart rhythm. An average pacemaker battery has about 0.5–2Ah of battery life. Factors controlling current drain with a pacing stimulus include pacing rate, per cent pacing, programmed voltage, pulse width (PW), and lead impedance. Energy use is proportional to PW and to the square of the voltage. By Ohms law, I = V / R , where R is the impedance, current is inversely proportional to impedance. For a given voltage ( V ) and PW, current will be less for a high-impedance lead. For an electrical circuit, a voltage drop occurs and energy is dissipated across a load or impedance. The area of high impedance in a lead should … *Corresponding author. Tel: +1 804 828 7565, Fax: +1 804 828 6082. Email: rshepard{at}mcvh-vcu.edu”

3. 3

   Device longevity of a leadless pacemaker family.

   Future cardiology (Leal et al.)Published Jul 16, 2025Checked Oct 12, 2026

   “To assess the device longevity impact of battery/electronics enhancements of next-generation Micra leadless pacemakers, Micra VR2 and AV2, compared to Micra VR and AV.MethodsReal-world pacing data gathered from the Micra IDE study, Medtronic's CareLink database, and historical pacemaker patient survival data from Medtronic's Device Registry were used to project device longevity and estimate the proportion of patients requiring lifetime device replacements.ResultsBased on data from 644 patients, the median projected longevity of Micra VR was 12.3 years and Micra VR2 was 16.7 years, with 91% of patients requiring a single VR2 device over their lifetime. Based on data from 999 patients, the median projected longevity of Micra AV was 10.8 years and Micra AV2 was 15.6 years, with 80% of patients requiring one AV2 device. The longevity improvements with Micra VR2 projected 8 fewer device replacements would be required across 100 patients. Similarly, 15 devices would be avoided when considering Micra AV versus AV2.ConclusionsModeling of the Micra leadless pacemakers projected meaningful improvements in device longevity and an increase in the number of patients served with a single device.”

4. 4

   Battery longevity of a helix-fixation dual-chamber leadless pacemaker: results from the AVEIR DR i2i Study

   EP Europace (Reddy et al.)Published Jun 1, 2025Checked Oct 12, 2026

   “Programming and diagnostics were interrogated from all de novo, non-revised, dual-chamber programmed devices at 12 months post-implant. This analysis included 302 patients (65% male; age 70 ± 13 years; weight 80 ± 19 kg; intrinsic heart rate 55 ± 7 bpm; 58% sinus node dysfunction, 27% atrioventricular block). At 12 months, devices were programmed to dual-chamber pacing (DDD(R) or DDI(R)) at a median 60 bpm rate, median 1.25 V pulse amplitude in ALP and 1.5 V in VLP, median 0.4 ms pulse width, and median i2i signal setting level 5 out of 7. Median ALP and VLP remaining battery longevities at 12 months were 4.3 and 9.1 years, with median total ALP and VLP longevities of 5.3 and 9.9 years. Base rate, pulse amplitude, pacing percentage, event rate, impedance, and i2i setting level all exhibited significant correlations with ALP and VLP longevities (P < 0.001). Programming i2i setting levels below 7 produced the greatest longevity savings. The first dual-chamber LP demonstrated adequate projected battery longevity after 12 months of use. Patient-specific device programming considerations, unique to leadless devices, may extend longevity.”

5. 5

   Actual Pacemaker Longevity: The Benefit of Stimulation by Automatic Capture Verification

   Pacing and Clinical Electrophysiology (Biffi et al.)Published Mar 8, 2010Checked Oct 12, 2026

   “One hundred twenty-six of three hundred patients completed the study. Adverse clinical events due to an increased RV threshold occurred in two FOP patients compared to none among ACP. Pacemaker replacement occurred in 1/34 ACP patients versus 60/92 FOP patients (P < 0.001). ACP was the single independent predictor of pacemaker longevity at multivariable analysis (hazard ratio = 0.03, P < 0.001) either in the overall population or in the specific patients subgroups (sick sinus syndrome, atrioventricular block, and neurally mediated syncope). Automatic verification of stimulation is reliable at long term, and warrants superior safety in the event of pacing threshold changes. It allows a significant longevity increase compared to FOP stimulation that may heavily impact the patients' quality of life and the cost of pacing therapy. Moreover, it is a fundamental technology in a strategy of remote patient and device monitoring, and may enable automatic device follow-up operated by trained, nonmedical personnel.”

6. 6

   Types of Complications and Associated Factors in Patients Undergoing Permanent Cardiac Pacemaker Implantation: A Systematic Review

   Journal of Multidisciplinary Healthcare (Sugiharto et al.)Published Jan 1, 2025Checked Oct 12, 2026

   “This review analyzed 15 articles. The analysis showed that there are five categories of factors which influences the incidence of complications in patients after PPM implantation: demographic, pre-existing clinical, comorbid disease, procedural, operator experience, and activity factors. The complications that are most frequently reported are generator erosion, pacemaker infection, pneumothorax, atrial lead displacement, battery depletion, and even death after PPM implantation. There are many incidents of complications and factors that influence complications in patients after PPM placement. The reported complications underscore the importance of careful patient selection and procedure execution to minimize risks. Healthcare providers should emphasize patients with risk factors to provide targeted monitoring and management.”