First-time fitment of smallest pacemaker in the UK

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Medics have revealed that the smallest pacemaker in the world has been fitted inside a UK patient’s heart.

The fitting of the Micra Transcatheter Pacing System was used for the first time in England during surgery at Southampton General Hospital.

Professor John Morgan, a consultant cardiologist, has marked the procedure as a ‘landmark moment’. He said the device was no bigger than an antibiotic pill and was only about one tenth the size of a traditional pacemaker.

Presently, pacemakers which make use of electrical impulses to regulate the heartbeat are inserted underneath the skin and connected to the heart by a lead. The lead is responsible for carrying electrical signals to adjust irregular or slow heartbeats, however they often need to be replaced because of dislodged or broken wires.

The new pacemaker is able to be implanted directly into the heart and the electrical impulses are delivered by an electrode, which removes the requirement for a lead.

Professor Morgan said that the advantages of size and the wireless technology are increased as the procedure reduces recovery time and the risk of infection associated with the more invasive surgery required for traditional pacemakers. He said that this is a massive step forward for patient treatment and a milestone in cardiac rhythm management in England.

Advantages

The new device offers patients several advantages.

• The absence of a lead or wire to deliver the electrical impulses to the heart from the traditional device. The wires are often placed under immense pressure which could cause complications

• Traditional pacemakers are normally placed under the skin in the chest, which places the patient at risk of infection. The smaller device is inserted with a catheter going from the groin to heart

• The new device which was used at Southampton General is the smallest pacemaker globally. It weights 2g and is only 26mm in length.
The first person to have the device implanted during December 2013 was based in Austria. Southampton General is the only hospital in the UK to take part in a global clinical trial of the new device.

There is a rival device named Nanostim from St Jude Medical, measuring 41mm in length, which is in the trial phase.

A third device by EBR Systems, currently in the development stage, combines an under-the-skin device which sends ultrasound energy to an electrode wirelessly. It will be about the same size as a grain of rice and will be implanted into the patient’s left ventricle.

Image Credit: Artur Bergman

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