Lifesaving devices often come in small packages BY SUE WEBBER CONTRIBUTING WRITER An otherwise-healthy 73-year-old man experienced a series of fainting spells that finally were relieved with the implantation of a heart pacemaker. The device to pace his heart was surgically inserted below the skin under his collarbone on the left side of his chest. The pacemaker is connected to his heart by one or more wires. If his heartbeat falls below 60 beats per minute, the pacemaker sends signals to his heart to keep the level above 60. Pacemakers work only when needed. They go on when the heartbeat is too slow, too fast or irregular. “I’m not aware of its being there; I don’t feel a thing,” the patient said. The pacemaker is checked periodically throughout the year, via a telephone call to his cardiologist, or a visit to the doctor’s office. “My cardiologist once said, ‘You know, it wasn’t too many years ago that you wouldn’t have lived with that condition,’” the patient said. The lifesaving results of pacemaker use continue with additional medical advances. True to the adage that good things come in small packages, Medtronic has in the last year perfected and introduced two small devices destined to help people with heart conditions. In December 2013, the Fridley-based company announced the first in-human implant of the world’s smallest pacemaker, the Micra Transcatheter Pacing System (TPS). It is one-tenth the size of a conventional pacemaker and comparable in size to a large vitamin pill, the company said. In February 2014, the company launched its Reveal LINQ Insertable Cardiac Monitor (ICM) system, the smallest implantable cardiac monitoring device available for patients.
Miniature pacemaker The Micra TPS goes directly into the heart through a catheter inserted in the femoral vein. The device does not require the use of wires to connect to the heart, but is attached to the heart via small tines that deliver electrical impulses to pace the heart through an electrode at the end of the device. “Traditional pacemakers have wires weaved into the heart, but the Micra has no leads or wires,” said Joey Lomicky, senior public relations specialist in the Cardiac and Vascular Group at Medtronic. “It’s fully self-contained.” Pacemakers are small implantable medical devices that are prescribed for people whose hearts beat too slowly or irregularly. A pacemaker stimulates the heart muscle with precisely-timed pulses of electricity that cause the heart to beat in a manner similar to a naturally occurring heart rhythm. A normal heart beats about 100,000 times a day. Modern pacemakers, averaging 70 pulses per minute (depending on the need of the patient), generate about 36 million pulses a year. Someone with a slow or weak heart rhythm may feel dizzy, weak or very tired. An implantable pacemaker may Above and below right, the LINQ Insertable Cardiac Monitor is one-third the size of a AAA batthen be used to restore a consistent flow tery. Below left, a Micra TPS pacemaker is about the size of a nickel. (Submitted photos) of proper electrical impulses, thus improving blood circulation and restoring a general feeling of well-being to the patient. Although people of all ages receive pacemakers, 65 percent of pacemaker patients are between the ages of 50 and 79. About 30 percent are 80 or older and less than 5 percent are under 30. In contrast to conventional pacemakers, the TPS does not require a surgical incision in the chest and the creation of a “pocket” under the skin, eliminating any visible sign of the device. DEVICES - TO PAGE 5