What happens at a device check?

It is quick and non-invasive, with no needles. A physiologist places a wand or programmer over the device, which reads it wirelessly. The check reviews the battery, how the leads are working, the settings, and any recorded rhythms or (for an ICD) delivered treatments, adjusting settings if needed.

What is remote monitoring?

A bedside transmitter or smartphone app that automatically and wirelessly reads your device and sends the information to your clinic, often overnight. It can reduce in-person visits and flag developing problems earlier. Your clinic sets it up and tells you how to keep it working.

How long does the battery last, and what happens then?

Several years, depending on the device, how much it paces, and its settings, so no single figure fits everyone. The device warns well ahead (the elective replacement indicator), which is planned, not an emergency. The generator box is then replaced in a smaller procedure, usually keeping the existing leads.

Pacemaker & ICD Checks and Remote Monitoring

Q: Is remote monitoring an emergency service?

No. It transmits at set times and is a monitoring tool, not an alarm line. If you collapse, have chest pain, feel very unwell, or an ICD shocks you and you feel unwell or you get more than one shock, call 995. Do not wait for the monitor to send data.

Q: What if there is a device recall?

Recalls and advisories are managed by your device clinic, which tracks them and contacts affected patients with advice. Most are handled with closer monitoring rather than surgery, so there is no need to panic. Keep your appointments and respond if the clinic contacts you.

Written & reviewed by the BestDoctors.sg editorial team · Last updated 28 Aug 2026 · General information, not medical advice

A pacemaker or ICD is not fitted and forgotten. It is checked regularly for the rest of its life, to make sure the device and leads are working, the settings are right, and the battery is healthy. Increasingly, much of this is done from home through remote monitoring. This guide explains what checks involve, how home monitoring works, and what happens when the battery eventually needs replacing.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

This is general information and does not replace your team’s advice. Remote monitoring is not an emergency service: if you feel very unwell, collapse, or an ICD delivers a shock and you feel unwell or receive more than one shock, call 995. Keep your device-clinic appointments and respond if the clinic contacts you.

Regular checks

Devices are checked regularly at a pacemaker or device clinic, and this follow-up continues for life. There is often an early check a few weeks after the implant to confirm the wound has healed and the leads have settled, then checks at intervals set by your team, usually at least once a year. These appointments are how problems with the battery or leads are picked up before they cause any trouble, so keeping them matters.

What a check involves

A device check is quick and non-invasive, with no needles. The cardiac physiologist places a small wand or programmer over the device, which communicates with it wirelessly and reads its information. There is nothing to feel. The check reviews the battery status, how well the leads are working, the programmed settings, and any heart rhythms or events the device has recorded, and the settings can be adjusted there and then if needed.

What checks look for

Checks look at several things. They confirm the battery has plenty of life left, that the leads are delivering and sensing properly, and that the settings still suit you. For an ICD, the check also reviews any treatments the device has delivered, such as pacing bursts or shocks, which helps the team fine-tune the settings to reduce unnecessary shocks. If the device has recorded any abnormal rhythms, these can be reviewed too, giving a detailed picture of how your heart has been behaving.

Remote and home monitoring

Many people now have remote, or home, monitoring. A small bedside transmitter, or in some systems a smartphone app, automatically and wirelessly reads the device and sends the information to your clinic, often overnight while you sleep. This can reduce the number of in-person visits and, importantly, can flag a developing problem, such as a lead or battery issue or a recorded arrhythmia, earlier than waiting for the next appointment would. Your clinic sets it up and tells you how to keep it working.

Not an emergency line

It is important to understand what remote monitoring is not. It usually transmits automatically at set times, and it is a monitoring tool, not an alarm or emergency service. It does not replace calling for help if you feel acutely unwell. So if you collapse, have chest pain, feel very unwell, or an ICD shocks you and you feel unwell or you get more than one shock, call 995, do not wait for the monitor to send data. If your home monitor shows a persistent fault or a not-transmitting warning, contact the clinic, since it cannot help if it is not sending data.

Battery life and replacement

The battery lasts several years, with the exact time depending on the type of device, how much it is pacing, and its settings, so no single figure fits everyone. As the battery nears the end of its life, the device gives plenty of warning, an indicator the clinic watches for, sometimes called the elective replacement indicator. This is planned, not an emergency. When the time comes, the generator box is replaced in a smaller, shorter procedure, usually under local anaesthetic, and the existing leads are normally kept and reused if they test well, with leads only replaced if they are faulty.

Recalls and keeping in touch

Occasionally a manufacturer issues a safety advisory or recall about a device or lead. These are managed by your device clinic, which tracks advisories and contacts affected patients directly with advice; most are handled with closer monitoring rather than immediate surgery, so there is no need to panic, just follow the clinic’s advice. Above all, keep your appointments, keep your home monitor set up as instructed, and respond if the clinic contacts you. These regular, and mostly effortless, checks are a big part of the reason that cardiac devices are so safe and reliable over the many years that people wear them. In Singapore, your hospital device clinic runs your checks and remote monitoring.

Sources

NHS – Pacemaker implantation: nhs.uk
Arrhythmia Alliance – Implantable cardioverter defibrillator (ICD): heartrhythmalliance.org
Medtronic – Remote monitoring of cardiac devices (patient): medtronic.com
Arrhythmia Alliance – Patient resources: heartrhythmalliance.org

General information only. This guide supports, but does not replace, the advice of your cardiology team, who fit and program your device and tailor your care. Always carry your device identification card, and tell any doctor, dentist, surgeon or radiographer that you have a cardiac device before any procedure or scan. Never assume an MRI is safe. Call 995 if an ICD delivers a shock and you feel unwell (chest pain, breathlessness, dizziness or fainting), if you receive more than one shock in a short time, or if someone with a device collapses: start CPR and call 995, as it is safe to touch them. Do not drive until your cardiologist and the traffic authority have cleared you. If you are struggling emotionally, you are not alone: the Samaritans of Singapore (SOS) are on 1767 and mindline.sg on 1771.

Pacemaker & ICD Checks and Remote Monitoring (Singapore)