World’s smallest pacemaker saves 76-year-old woman

The world’s smallest wireless pacemaker was successfully implanted in a 76-year-old woman at Paras Hospital in Gurugram without an invasive surgery.
A team of cardiologs, led Dr Amit Bhushan Sharma, Director & Unit Head, Cardiology, Paras Hospital, performed the procedure using an advanced version of the Micra Transcatheter Pacing System, which is the smallest leadless pacemaker in the world. The whole procedure was done non-surgically implanting the capsule-sized pacemaker through the leg vein, restoring the woman’s normal heartbeat.
The patient had undergone angioplasty previously but her blackouts and resultant falls continued. It was only after she fell unconscious and hurt herself yet again that she was brought to the hospital. That’s when Dr Sharma realised that her blackouts were due to her weak heart and slow heart rate. “When she was brought to the emergency room, doctors immediately put her on a temporary pacemaker so that her heart rate could stabilise. Then we decided to put in a permanent pacemaker the size of a vitamin-C capsule. Since she had already had many bruises and was on blood thinners, we decided to implant the pacemaker through the leg vein. She was discharged in a couple of days,” said Dr Sharma. “Normally the pacemaker is the size of a matchbox, and this involves cutting off the chest below the collar bone, but this small pacemaker requires a minimally invasive procedure. We can say the new pacemaker works on the no-scar-no-bump procedure,” he added.
The normal pacemaker causes a bump near the chest bone and the patient has to get used to it after some time. But the new pacemaker goes directly inside the heart muscle, so it is not visible to patients or others after the surgery. “Our patient had an electrical conduction system durbance wherein the heart becomes weak often with age. As a result, suddenly the heart rate drops down to 25-30 or the heart beating stops. When there is no blood supply to the brain, the patient becomes unconscious. Such patients do not have chest pain but face blackouts,” he added.
There is neither any need to stop blood thinners while implanting this pacemaker, nor any cut in the chest. Normally, pacemakers come with a lot of restrictions. For example, patients cannot raise their hands above the shoulders for four weeks after the implantation, cannot use the mobile phone from the left side or put it in the left side pocket. However, these restrictions are no more required with the new pacemaker.