By Cindy Foster

UNM Hospital Now Offering Patients the World’s Smallest Pacemaker

Visualize a large vitamin capsule crowned with tiny fishhooks and you will have an idea of the size and looks of the world's smallest pacemaker.

University of New Mexico Hospital just began offering the pacemaker for patients with Michael Bestawros, MD, performing the first two operations on the same day.

Known as the Micra® Transcatheter Pacing System (TPS), the new single heart chamber technology makes it possible for patients who might not otherwise qualify a pacemaker to receive one for the treatment of bradycardia.

Most pacemakers are dual chamber so there is only a small percentage of patients who can benefit from a single chamber. But for those people, the tiny new leadless implant can be nothing short of "revolutionary" Bestawros says.

"Most often the group that benefits from this are elderly, frail and with thin skin - the kind of person who you don't want to have to pierce the skin in order to insert a pacemaker," he says.

With bradycardia, the heart beats slowly - usually fewer than 60 beats per minute. That is too low to ensure adequate oxygen-rich blood pumps throughout the body and it can lead to a host of complications including dizziness, fatigue, shortness of breath or fainting spells.

Traditional pacemakers require cardiologists to make an insertion in the chest and patients can often feel the battery through the skin, he says.

Not so with the new pacemaker.

The tiny size means cardiologists can forgo opening the chest - and risking possible complications. Instead, they can use a catheter to thread the pacemaker up through femoral vein of the upper thigh into the heart chamber. One there, tiny tines atop the unit fasten directly to the heart wall.

"Patients do not have the constant reminder of a piece of hardware they can feel in their chest. You won't even know this is there," he says.

Being implanted without having to make incisions also cuts significantly the time needed for the procedure. While traditional pacemakers take around a half hour to complete, the average for the new one is 22 minutes and one of the first operations at UNM was finished in just 14 minutes, Bestawros says.

Both patients at UNM were in their 80s and had medical conditions that would have made a traditional implantation problematic, according to Amy Ruane, unit director for the Cardiac Cath Lab and Heart Station says.

Another unique feature is that the devices can be turned off but left on the heart wall when it is time to insert a new one. There have been cases of up to 3-4 devices left in place, according to Bestyawros.

While the devices have just come on market during the past few months, they have been the subject of research for years.

With more research, he believes the new technology will evolve to replace the bulkier double chamber pacemakers on the market today.

"That will be a game changer," he said.