NOTE: I am not a doctor and have no medical training.
I’m writing this post mostly because I couldn’t find any information on the internet when I needed it. Seven years ago (next month), I had a defibrillator implanted in my chest. It was recommended after a heart attack left me with a low EF, meaning my heart was damaged and not functioning as well as it should. It puts me at risk and the defibrillator is there to help in those situations.
In seven years, it has never triggered the full shock it can deliver, and next month it is due to be replaced due to a low battery condition. This isn’t about the low battery.
I have a defibrillator made by Medtronic. Every morning (the time can be changed by a tech) it does a check and if there’s a problem it will let you know with a series of tones. When the battery is low, it will generate a warning every morning at that time. Mine started generating that error last month and the technicians turned off that alert in the office during one of my visits so it wouldn’t keep bugging me.
A few weeks later, I was standing in line at the bank and this started:
It’s the same sound as the low-battery warning, so I thought that they may have just snoozed the alarm, but an hour later it sounded again, so I called the pacemaker/defibrillator clinic I go to and left a message. It was towards the end of the business day, so I guess I missed them. I didn’t get a call back. Four hours later, it beeped again. And four more. And four more. I figured the beeping during sleeping hours was probably a sign that this was more serious than I first thought, so I called the electrocardiology office.
Fortunately, my doctor was on call that weekend. He went to his office and had me upload the data from my device. After having a chance to review it, he told me the error was an indication of some irregular voltage readings, that could indicate a break in the leads. He sent me to the ER.
I spent the rest of the day in the ER getting X-rays and waiting for a Medtronic tech to run more thorough tests on the device. The technician told me that he had never encountered this condition in his twelve years of working for the company, but that he had been given a series of special steps to follow that would allow them to figure out if there was a break or related problem with the wiring.
The X-rays and tests didn’t reveal the source of the problem. Everything looked fine, so they decided to reset the error flag in the device and keep me overnight for observation. I went through the night without another alert and was tested again in the morning.
It was later explained to me that the fault was registering in what I think he called a coil. There are two of those and fortunately, the one that was indicated as the source of the problem could not generate a false condition that would trigger a full shock to my heart from the defibrillator. The other, however, could have. (Obviously, that’s quite dangerous and explains why they wanted me there overnight.)
If anything else happened while I had been there (or the beeping starts again while I’m home), they’ll want to move up my replacement surgery. I’m glad that there’s some time in-between. If this happens again, I’d much prefer it to be before the replacement than after, so they can deal with both the wiring and the device at the same time. (Replacing the wiring comes with risk, so I’m hoping it doesn’t come to that.)
Anyhow, if your device is beeping every four hours, or even just once has that tone in the video, you should probably call your doctor and upload the data from your device. Don’t wait it out. If your problem happens to register in a different location of the wiring/device, you could be in serious danger. Good luck.
Complete list of posts in this series
Defibrillator Saga 1
Defibrillator Saga 2
Defibrillator Saga 3
Defibrillator Saga Conclusion
If one would have read this just some years ago, it would have been cyberpunk fiction AF. Uploading your data and sending it to your doctor, having your coils checked and so on… TotalRecall stuff!No wonder you started a scifi magazine. On a more serious note, you are living in the most high tech country in the world, so that definitely helps with lessening the worries (I hope) and I am sure everything will be all right. Best wishes, Neil! Don’t lose your sense of humor, it’s the best defense in such moments!
ty so much for posting this , my dad has same device doing this now.
You’re welcome. Best of luck to your father. Hopefully it turns out to be a simple fix. Mine wasn’t. After this post, it started beeping again and further diagnostics revealed a lead failure during my second stay in the hospital. They disabled that portion of the defibrillator via software and I was allowed to go home again. Ultimately, I had to have a specialist remove and replace the device AND the leads, which is significantly more complicated than the device replacement, particularly if the leads have been in there for more than a few years. (Like mine.)
Thanks for the post. I am on my third pacemaker/combined defibralator and
This one was just replaced in September 2020. Just was in office for check and just this morning 7am had that truck back up noise you posted . Last time indicated low battery which system and leads were replaced. Hope I don’t need surgery and replace again. Calling DR for appointment.
Wishing you all the best. If it’s beeping every four hours, they’ll probably prioritize you and get you in quickly. Hopefully you won’t need another replacement so soon.
Neil can you tell me if the alarm runs down the battery/device please and thank you for making yourself available to people like ourselves
The alarm does run off the battery. The technicians didn’t tell me anything about how much of a drain it was, but they did tell me that the low battery thresholds vary by the policies of the places that install them. Most use the defaults, but they can be changed. The thresholds are usually set to levels where it could still power a full defibrillation sequence, which is much far more power than I’d expect an alarm to need.
Wow I love google, my wife has had a pacemaker since 1995 (18 year old) and an icd since 2011, her alarm just started sounding last week, a few nights stay in the hospital and lots of tests revealed 2x faulty leads (high imepediance) they too turned off the alarm as her health and heart are fine and are working out how to change her 2 leads which are 20 + years old
Both leads failed?! She’ll probably have a procedure similar to mine to remove and replace them. (Some more details here http://neil-clarke.com/defibrillator-saga-part-two/ and http://neil-clarke.com/surgery-on-thursday/ and http://neil-clarke.com/defibrillator-saga-hopefully-the-end/)
Best of luck!
Hi, interesting reading! I will be having my Medtronic ICD replaced as my battery has about four more months of life. Do you know what grace period we have if it starts beeping before surgery? Can’t find anything on Medtronic site and techs tell me “ it depends “. Posted March 4 2021.
I have a recollection of one of the techs telling me that the low battery warning was set to reflect a certain percentage of battery remaining, rather than a particular amount of time remaining. The idea was to give a sufficient grace period for scheduling the replacement. Different owners will run down the battery at different speeds based on how often the device activates, so the percentage is can be more than generous in most cases. I believe they can silence or lower the setting on the low battery alarm. It’s really more there to get you to be proactive about scheduling. If the beeping is happening every few hours, however, that’s possibly something a bit more urgent than a low charge.
Wow thanks! Just had defibrillator inserted in November so 5 months ago!
And it’s making that same noise every morning at 7am…has happened two mornings in a row have booked a gp appointment so hopefully nothing happens before then!
Good luck! Did they have you transmit data to their office?
I have had my defibrillator put in of February this year 2021. In May was the first time the alarm went off sounding like an ambulance. That was 5am while sleeping and continued to go off every 4 hours around the clock until I got into the office to have it fixed. When I asked why this happened she said it was because the defibrillator went out of range. I don’t understand…out of range from what? So here I am 2 months and one week later July 2021 and then again this morning at 4am it went off again for about 3 seconds but then at 5am it is back to the Long length alarm again and then again at 1pm. So it looks like it will be a repeat from May, 5am, 9am, 1pm, 5pm around the clock until they can get me in there to fix it once again. This is ridiculous and frustrating. Plus the fact they charge me for an office visit for the malfunction of their device!! I have only had this defibrillator for 4 months and it has already malfunctioned 2 times. I am truly disappointed.
When they say out-of-range, they are talking about the lead impedance. If I recall correctly, the out-of-range boundaries can be adjusted, but are defaulted to the company’s recommended range. It will probably take them some work to figure out what is triggering that. They were unable to find anything wrong during my hospital stay, but in further posts in this series, I outline what they eventually found, the severity of the situation, and how it ended up requiring defibrillator and wiring replacement. Best of luck to you!
Mine has been beeping but it sounds like a alarm clock but it does it for 10-15 seconds then stops but it does it every few hours idk what’s wrong would greatly appreciate if Someone Could tell me if they know what’s wrong kinda scaring me
Call your electrocardiologist. They will probably have you upload data from your device and/or have you come into their office for diagnostics. Even though it is the weekend, someone from their office should be on-call. If you can’t get anyone, someone in the local hospital emergency room should be able to figure out why it’s happening. No one will blame you for being overcautious with something like this. Best to be on top of it rather than wait.
Thanks to you and Google I have an answer. Mine is also going off every four hours. Device clinic nurse told me he’d call in morning with device report…it’s both wonderful and scary to have a device directly attached to your heart that could shock you! Thanks for sharing so we all know not to take this too lightly. Medtronic basically says be alarmed but not too alarmed which is counterintuitive since it’s a damn ALARM in my chest. Haha
You’re welcome! Wishing you the best of luck and a safe & speedy resolution.
The posts in this series get a surprising amount of traffic. Medtronic clearly needs to work on their website content. Doesn’t look like it’s improved much since all this happened to me.
I thank you very much for this post. My son’s started beeping today, Easter Sunday and Medtronic had nothing on their website about what it could be. We knew he was reaching end of life for the battery. Your post was very informative. The video was helpful too, he could confirm that was the same sound. I was at work when it happened.
You’re welcome! Hope all is well and your son’s battery replacement goes smoothly.
Does anyone know if an ICD alarm stops alarming on its own or does it have to be a hospital visit to turn it off or can it be done remotely ?
From what I have been told, this can’t be done remotely. Settings changes require the base unit that they use when you have an in-person diagnostic. It’s a safety thing. They turned mine off at my electrocardiologist’s office.
My device gave me an appropriate shock. I received another surprise when my device alarmed (siren noise) every day until I attended a cardiac unit and had the alarm reset. I am now going to investigate if it’s possible to turn off the alarm permanently.
I’m guessing your shock was the big jolt. Haven’t had that myself, but I was told that if I did, I was to report in right away. Not surprised that they have it rigged up with a alarm to get you to go into the office. They want to run diagnostics after those.
In the conversations I had with the techs who were trying to figure out what was going on with my defibrillator, I learned that the alarms are configurable. They can change the thresholds for some triggers, which, in theory, would suggest that they can disable it. The nagging every four hours alert is to make sure even the most reluctant patient eventually comes in (or has a family member drag them in). Apparently, it’s saved more than a few lives, so I’d bet they’ll be reluctant to turn it off.
RANDOLPH M BOILEAU
I had a Medtronic unit installed 16 days ago. After 8 days it started giving alarms. Yesterday I went in had the incision reopened and adjustments made. Today it started to give alarms again. Very, very frustrating.
Oh that’s awful. Mine was in for years before the errors started happening, but it took some time to work out why. Can’t imagine dealing with that during recovery. Best of luck to you.
Well i also have a medtronic defibullator implanted about 6 yrs ago bcuz they discovered i have heart failure and i was 39 yrs old with EF at 20-25% and thats y they chose to implant one.. Now i just turned 45 a week ago and its at less then 5% but yeah im dealing with the fact that ill b gone soon but i have noticed a few days n a row at 10:11am mine starts sounding off like a lil alarm or something…not sure!! Nothing hurts or feels any different but im just wondering what could that sound b and is it something that i should go to my dr about.. I mean i know its important bcuz it has to do with my heart but i dont want to over react.
You should call your electrocardiologist’s office today. I was told that anytime you hear that alert you should call them. They expect it and you won’t be wasting their time. It will keep going off until you do so, just to nag you into calling them. The critical alert goes off every four hours. The only once-a-day alert I’ve experienced is the low battery warning, which based on how long you’ve had the device is certainly possible.
Most likely they’ll want you to come in. The only way to mute that alarm is to do it in person. If it’s the low-battery alert, like mine, they’ll want to schedule your replacement and turn that warning off (most likely just set monitor for an even lower percentage). There are other warning conditions too.
I have heart failure due to Cardiac sarcoidosis which caused scarring and complete block. My EF got down to 17% and I also thought I was a gooner. Yet, I started a new drug protocol of two medications. These are being used to treat low EF. I take Entresto and Jadiance. My EF is now 40% in the year I have been on them. Have you heard of this new treatment. If not ask you doctor and do some research. EF doesn’t always mean you will die soon, I go to heart transplant specialist at Duke in NC and he says it is not the most important factor in heart failure.
My device started making a beeping noise a week ag, been to see a technician twice and they keep telling me that is nothing wrong with the device. But still is making a noise and they keep telling me they can’t hear it, I don’t know what else to do I don’t think they believe me, I am very frustrated, what can I do
Is it only beeping occasionally or at regular intervals? If it’s irregular, make note of when and where it is happening. Look for a pattern. The device can sound an alert if you are too close to a magnetic field. (I set mine off once with a pair of magnetized scissors.) That just means move away from the source and it’s nothing major. If the beeping is happening on a regular schedule, time a visit to when it should go off so you have witnesses. Short of that, record it with your phone like I did.
The device maintains a log of the system alerts (not sure if the magnetic warnings are logged) and why they happened. They should be able to see it via their standard diagnostics console. Did they hook you up to a monitoring station or have you do a remote upload? Should have shown on those.
I have a Boston scientific pacemaker and defibrillator. This is my second one. So far so good.
I have a Boston scientific pacemaker and defibrillator any problems?
Wow, reading all of your post and the comments has been so affirming! I haven’t been able to find this level of info anywhere and feel crazy.
I had my Medtronic pacemaker/defib placed in 2008 and have had 2 replacement batteries since then (last battery replacement was Feb 2020). All has been well until last month (Aug 2022). It’s now made that “ambulance” alert for 10-15 seconds on three separate occasions, many days apart from each other. The weird thing is, it always happens at 28 mins past the hour. So it’s been 1:28am, 5:28am, and then 9:28pm. I’ve called my doc and sent remote transmission but “no news is good news” and I haven’t heard anything. I’m going to bring up the lead issues that you mentioned! Thanks so much.
The device has a schedule for when it runs tests, so it isn’t surprising that you’d have a pattern like that. From what I understand the schedule for those tests can be set by a technician and where you get it done can influence that schedule. Mine was set for four hour intervals and once the error happened, it nagged me regularly until it was reset, whether or not the device still detected the fault. The interval between your alarms is irregular, which suggests that it passed some tests in the middle, but it didn’t have an error state that required the constant nagging mine did. Either way, they drilled into me the importance of speaking to them any time I heard that sound. Hopefully you can get some answers soon. Not knowing what was going on was a major source of stress and frustration. (It didn’t help that I couldn’t sleep with it going off every four hours.)
Reasons for ICD’s to Alert
Alerts made by a device will vary depending on the manufacturer and device type, but there are common reasons and these are listed below:
Your battery life is low
There is a fault with the device or lead(s)
You have received a therapeutic shock
There is magnetic field disabling or interfering with the device
The device has been unable to communicate with your home monitor for longer than the recommended time (2 weeks?)
Manufacturer Alert Type Tone Comment
Medtronic Audible 30 sec High Urgency
30 sec Low Urgency
10 sec solid
We did not know this! About 3 weeks into our Mexico vacation, and 6 weeks post insertion the CRT-D Pacemaker started to alarm st 7:11 every morning. At first we thought it was a person’s alarm clock the first few days!
Yesterday, we entered a coffee shop and it started again but in the afternoon, and every 2 minutes or so! We exited and it stopped! Then we figured out the metal sunglasses that attach to the glasses had been placed in the shirt collar and it was touching the CRT-D pacemaker! Lessons learned.
We had thorough teaching pre and post but no alarms were mentioned and we will let our Canadian clinic know.
Yes, a magnetic field will trigger a warning that indicates the device is disabling features to protect you and itself. I had the same thing happen with a pair of scissors that had become magnetized. That, however, generated a different tone than the siren sound that I had happening at regular intervals throughout the day. (Mine was exactly every four hours, but the interval can be set differently.) Next time they are checking you in the office, they should be able to demonstrate the tones for you. During my training, they did the “hey dummy get away from the magnet” tone, but not the more severe warning, so I was caught off guard when that happened.
When you have alerts at precise and regular intervals that is the device telling you that you should call in to the people that do your regular defib/pacemaker checks. You could be at risk of the device not working properly should you need it, or worse, activating when you don’t need it. In those situations they will probably have you do an upload or come into the office to get more data from the device. The regular repeating schedule is to nag you into reporting it. Apparently, a lot of people are content with having beeping sounds coming out of their chest. Some (I’m not sure how) are even able to sleep through it.
Medtronic Europe made a video about the tones (several months after my problems). It can be found here: https://www.youtube.com/watch?v=u82zUPw8Ac4
I so appreciate your quick response. Thank you, Neil. This string of comments has indeed been helpful in understanding alarms.
Wishing you all the best health wise.
Marc J. Sicklick, MD
I AM a physician.
I had my pacemaker implanted in 1995 and my defibrillator in 2005. Until January, 2023, I never heard an alarm.
I started hearing an alarm that I thought was my iPhone malfunctioning while on vacation. It was on numerous occasions throughout the day. My grandson told me that it was from my chest. He was correct.
We flew home and the alarm certainly sounds like the magnet alarm. It sounded over 20 times on vacation over two days in very different locations. It sounded in archeological sites, in open fields, in our hotel, and in the airport.
My entire device was changed and since that time, the same alarm has gone off at least once/ week. This is ON THE NEW DEVICE.
Medtronic says that I’m going near magnets. i find it difficult to believe that for decades I never had the alarm, and now it’s a frequent occurrence.
I have been told that it’s my magnetic sunglass clip-ons and or the magnetic eyeglass frames, but it can’t be reproduced. ( It has not happened when I was not wearing my eyeglasses.) I can place the eyeglasses and sunglasses on the device for hours and nothing happens.
It’s very frustrating.
That is very unusual. I’ve only had the magnet alarm happen from scissors (they had become magnetized, a screwdriver, the case for a tablet, and part of a doorframe that had a magnet to hold the door shut. I’ve had people tell me that the antitheft sensors in stores set theirs off, but it’s never happened to me, so I’m guessing the sensitivity levels vary. Good luck figuring this one out!