Developments

Blackrock Clinic Developments First miniaturised, leadless pacemaker successfully inserted into a patient’s heart at Blackrock Clinic

First miniaturised, leadless pacemaker successfully inserted into a patient’s heart at Blackrock Clinic

12th May 2016

Medtronic Micra pacemaker is smaller than a AAA battery

Patient discharged within 24 hours of procedure

Ireland’s first patient received a miniaturised, leadless pacemaker last week.   Fitted by Consultant Cardiologist and Electrophysiologist, Dr Jonathan Lyne, the Medtronic Micra Transcatheter pacing system is the world’s smallest pacemaker[1].  It is inserted into the right heart chamber by catheter via the femoral vein in the thigh.  It is smaller than a AAA battery.  The minimally invasive way of delivery reduces risk and trauma to the patient.

PACEMAKER

The benefits of the Medtronic Micra pacemaker include:

  • Almost instantaneous recovery – as the first patient who had undergone the procedure, Mr Cassells was kept overnight; however, other patients may be discharged within the day if there are no other complications;
  • Miniaturised – the Micra is 93% smaller than conventional pacemakers[2]
  • Resulted in 99.2% implant success rate, 0 dislodgements, 0 systemic infections in 725-patient global trial[3]
  • Designed to reduce complications related to pacemaker insertion by 51%[4] when compared to traditional pacemakers;
    • No box which removes the risk of erosion leading to infection, or forcing complete removal. Removal carries a 1-2% risk of mortality;
    • Leadless which removes the risk of blocked veins;
  • New ultra low-power circuit design delivers an estimated average 12-year battery longevity (where previous pacemakers had a life-span of between 6&10 years);
  • Designed to minimize tissue trauma during deployment, repositioning, and retrieval;
  • Can be turned off and an additional Micra can be added. Micra takes up <1% of the volume of a normal right ventricle;
  • If necessary, the Micra can be turned off and a traditional system or upgrade can be implanted or it can be retrieved to enable acute retrieval[5].

The 82 year-old patient, Mr Peter Cassells commented: “The whole thing was easier than going for a hair cut.  I was sedated but I was still fully alert and able to watch the whole process on the screen as it happened.  It was fascinating”.

Dr. Jonathan Lyne is the only consultant in Ireland who is trained in the delivery of the Medtronic Micra Transcatheter Pacing System.

He commented: “One of the biggest issues for the users of pacemakers is erosion where, over time, the older pacemakers need to be completely removed as they slip, become more visible under the skin, more uncomfortable and in some cases, can cause infection.  Also, the leads can cause blockages in the veins.  The size, location and leadless nature of the Micra are designed to eliminate these complications”.

“After the success of this procedure, it would be hoped that soon, the Micra will be the norm for pacemakers in appropriate patients,” he added.

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[1] Nippoldt, Doug; Whiting, Jon. Micra Transcatheter Pacing System: Device Volume Characterization Comparison. November 2014. Medtronic Data on File.

[2] Williams, Eric, Whiting Jon; Micra Transcatheter Pacing System Size Comparison, November 2014, Medtronic Data on File.

[3] Reynolds DW, Duray GZ, Omar R, et al. A Leadless Intracardiac Transcatheter Pacing System. N Engl J Med. Published online November 9, 2015

[4] Reynolds DW, Duray GZ, Omar R, et al. A Leadless Intracardiac Transcatheter Pacing System. N Engl J Med. Published online November 9, 2015

[5] Eggen, Mike. FlexFix Tine Design. April 2015. Medtronic Data on File.

Dublin man fitted with world’s smallest pacemaker – RTE News.