I think with all the theory, we might confuse 'ol exeter. After reading his original post, I think his heater is fed with 110V but wired internally for 220V. He did say it was a combination unit.
But if he decides to replace it with a 220V unit, he can do it with the present wiring that is installed. The spare breaker from the water tank may be a bit too large for the heater. Some HWH need a 30 amp breaker, where the heater will only need a 15 or 20 amp breaker.
Exeter, let me know if you need anymore help with this.

Jerry