Rechargeable Pacemaker Technology in Deep Brain Stimulation: A Step Forward, But Not for Everyone

Abstract

Background: Rechargeable implantable pulse generator (IPG) technology has several advantages over non-rechargeable systems and is routinely used now in deep brain stimulation (DBS). Little is known about the occasional need and the circumstances for switching back to non-rechargeable technology. Cases: Out of a cohort of 640 patients, 102 patients received a rechargeable IPG at first implantation or at the time of replacement surgery. Out of these, 3 patients underwent preemptive replacement with non-rechargeable devices for the following reasons: dissatisfaction with handling and recharge frequency (pallidal DBS in advanced Parkinson's disease/dystonia), severe DBS OFF status subsequent to missed recharging (subthalamic DBS in Parkinson's disease) and twiddler's syndrome (nucleus accumbens DBS in alcohol dependency). Conclusions: Although rechargeable IPG technology has been received well and is used widely, there are unexpected scenarios that require replacement surgery with non-rechargeable IPGs.