City patient receives world’s smallest pacemaker
THE world’s smallest pacemaker, comparable to the size of a large vitamin, has been fitted into the heart of a Brackenfell resident.
The minute pacemaker is lead-free, and at 6.7mm in diameter and 25.9mm in length is only one-tenth the size of an ordinary one. It was implanted directly in the right ventricle of 74-year-old patient Joan van Niekerk’s heart.
Dr Razeen Gopal, of Cardiac Electrophysiologist at the Cape Town Atrial Fibrillation Centre at Mediclinic Panorama, performed the procedure, along with three more implantations, to complete the first post-FDA approval series of commercial intracardiac pacemakers in Africa.
He was assisted by consultant cardiologist and electrophysiologist Dr Raed Sweida from Jeddah, Saudi Arabia.
“It is cosmetically invisible and is small enough to be delivered through a catheter via the femoral vein in the groin and implanted directly into the right ventricle of the heart, providing a safe alternative to conventional pacemakers without the complications associated with cardiac wires,” Gopal said.
The pacemaker is attached to the heart with small tines, allowing it to deliver electric pulses that pace the heart through an electrode at the end of the device.
Unlike traditional pacemakers, it does not require lead or a surgical “pocket” under the skin, eliminating potential complications, the most feared being infection.
It responds to patients’ activity levels by automatically adjusting therapy. It is a rate-responsive device with a sophisticated, built-in accelerometer that can distinguish between the heart’s natural beating rhythm and the movements of the patient.
Mediclinic Panorama general manager Riaan Vorster said: “It is important for our patients that they can benefit from such technology.
“The research has shown that the intracardiac pacemaker has very low complication rates and that there was a significant reduction in health-care utilisation compared to traditional pacemaking systems.
“We need to offer solutions that are going to positively impact our patients’ lifestyles.”
While the device is designed to be left in the body, with an average battery life of about 10 years, it incorporates a retrieval feature should this be necessary.
A second or even a third device can be placed in the right ventricle if necessary in future.