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World's Smallest Transcatheter Pacing System Provides Less Invasive Bradycardia Treatment

Cardiologists on the medical staff at The Heart Hospital Baylor Plano are now using the first and only leadless pacemaker in the United States as a treatment option for patients with bradycardia. The Micra™ transcatheter pacing system (TPS) is about the size of a multivitamin, making it 93 percent smaller than traditional devices and the world’s smallest pacemaker.

Because the Micra™ TPS is implanted during a minimally invasive procedure through the femoral vein, it avoids an incision or the need for a surgical “pocket” under the skin. The pacing system is implanted into the heart using small tines and delivers electrical impulses to pace the heart through an electrode at the end of the device.

“The actual implantation takes no more than 15-20 minutes,” said Hafiza Khan, MD, an electrophysiologist on the medical staff. “For physicians, it is exciting because of the ease of implantation. For patients, it provides convenience and a less invasive option in terms of patient comfort.”

Micra TPSAfter the procedure, patients are typically up and walking within hours, and some can go home the same day. Because it is leadless, patients do not have to wear a sling or worry about dislodging leads, potentially reducing complications.

It also provides another treatment option for patients who previously would not have been a candidate for pacemaker implantation. Patients who have a problem with their upper veins may still be able to get a Micra™ TPS.

Once implanted, the self-contained system is designed to automatically adjust pacing therapy based on a patient’s activity levels, and it has a battery life of 10-12 years. It is also the only transcatheter pacing system approved for both 1.5 and 3 Tesla full-body MRI scans.

According to Medtronic, the maker of the device, the Micra™ TPS has a 99 percent success rate and 48 percent less complications compared to the standard pacemaker. If the device does need to be removed or replaced, it includes a retrieval feature. The device also can be permanently disabled and left in the body without the risk of electrical interaction with any future devices.

Currently, the Micra™ ​TPS is only approved for patients needing a single-chamber pacemaker. However, it signifies an important step in developing leadless pacemaker technology.

“The Micra™ TPS paces the right ventricle, so it’s a single-chamber pacemaker,” Dr. Khan said. “The key is to expand it and refine the technology so that it could be an option for people who need a dual pacemaker in the future.”

The new transcatheter pacing system is one of many innovative treatments available at The Heart Hospital Baylor Plano for patients with arrhythmias​ . To schedule a patient for evaluation at the Arrhythmia Center, call 469.814.4864.​

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PHYSICIAN CONTRIBUTOR​​​

​​Hafiza H. Khan, MD​​​​​​