Middeldorp, M.Mahajan, R.Elliott, A.Pathak, R.Twomey, D.Wilson, L.Stolcman, S.Munawar, D.Kumar, S.Lau, D.Sanders, P.2017-08-152017-08-152017PACE - Pacing and Clinical Electrophysiology, 2017; 40(6):624-6280147-83891540-8159http://hdl.handle.net/2440/106879Background: Medical technology has made significant advances over the last few decades with smaller and more dynamic pacemakers. However, technical failures leading to premature replacement is a cause of concern. We present a series of Medtronic EnRhythm devices that reached premature elective replacement indicator (ERI). Methods: The database of Centre of Heart Rhythm Disorders was searched for EnRhythm device implantation from 2006 to 2011. Battery depletion <8.5 years was considered premature considering the projected average longevity to be 8.5–10.5 years. An unexpected premature ERI was defined when it was reached within 3 months of last normal check. Device follow-up was conducted every 3 months after advisory. Results: A total of 88 EnRhythm pacemakers were implanted. Over a median follow-up of 6.2 years (range: 0.3–9.2), 39 (44.3%) EnRhythm devices reached premature ERI. In 11 (28%), ERI was not recognized and patients were being investigated for other causes of unsteadiness or dyspnea prior to device check. Notably, three (7%) patients had premature ERI < 3.5 years. Ten (25.6%) had sudden and unexpected premature ERI. While asynchronous pacing was observed, there were no cases of absence of pacing. Conclusions: The rate of premature ERI for EnRhythm devices was 44.3%, significantly higher than reported by the manufacturer. Of concern, a sizeable proportion occurred unexpectedly, warranting more frequent reviews and empirical replacement in some patients. With the experience of the EnRhythm, appropriate monitoring strategies are recommended for future advisories.en© 2017 Wiley Periodicals, Inc.device recallselective replacement indicatorpacemakerremote monitoringJournal article003006602810.1111/pace.130730004034634000042-s2.0-85019031679293005Middeldorp, M. [0000-0002-4106-9771]Mahajan, R. [0000-0003-3375-5568]Elliott, A. [0000-0002-5951-4239]Pathak, R. [0000-0002-7391-6867]Munawar, D. [0000-0002-9273-8832]Lau, D. [0000-0001-7753-1318] [0000-0002-1564-439X]Sanders, P. [0000-0003-3803-8429]