Originally posted by the Voice of America.
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Tiny Pacemakers Could Be Game Changers for Heart Patients

by Carol Pearson

   WASHINGTON --

   Tiny, new pacemakers [1]are making headway around the world. One type,
   the Micra, is keeping 15,000 people's hearts beating in 40 countries,
   according to manufacturer Medtronic. One of those people is Mary Lou
   Trejo, a senior citizen who lives in Ohio.

   A healthy heart has its own pacemaker that establishes its rhythm, but
   people like Trejo need the help of an [2]artificial device.

   Trejo comes from a family with a history of heart disease. Her heart
   skipped beats, and she could feel it going out of rhythm. Trejo wanted
   to do something to advance heart health, so in 2014, she volunteered to
   participate in a clinical trial for [3]the Micra pacemaker. The device
   is 24 millimeters long implanted, one-tenth the size of traditional
   pacemakers.

   Traditional pacemakers

   Most pacemakers rely on batteries placed under the skin, usually just
   below the collarbone. Sometimes patients get infections after the
   surgery or have difficulty healing from the incision.

   Traditional pacemakers use leads with electrodes on one end that are
   threaded through blood vessels to connect to the heart. There can be
   problems with the leads as well.

   Dr. Ralph Augostini at Ohio State's Wexner Medical Center says a tiny
   pacemaker like the Micra avoids all of these problems.

   "The electrodes are part of the can, and therefore it eliminates the
   lead," he said. There's no incision in the chest to become infected and
   no chance of complications with the leads.

   Small and self-contained

   Augostini implanted Trejo's pacemaker in 2014. He threaded the entire
   device thorough an artery in her leg up to her heart. The pacemaker has
   small, flexible tines that anchor it into the folds of the heart
   muscle. Once it's in place, the doctor gives it a tug to make sure the
   pacemaker is stable before removing the catheter used to place it in
   the heart.

   The Wexner Medical Center was one of the sites that participated in the
   Micra clinical trial. Since the Micra received FDA approval in 2016,
   Medtronic has been training more physicians on the procedure. A company
   spokesman told VOA that this device is becoming available at other
   centers across the U.S. and countries throughout the world.

   Dr. John Hummell, a cardiologist at the Wexner Medical Center, has
   studied the effectiveness of this new generation of pacemakers.

   "We don't leave any wires behind and the pacemaker, the battery, the
   wire is all just a tiny little piece of metal sitting down in the
   heart," he said. Medtronic said the results of the clinical trial
   showed a success rate of 99.6 percent.

   Dr. Richard Weachter, with the University of Missouri Health Care, says
   the leadless pacemakers' complication rates are about half the rate of
   traditional pacemakers.

   The battery lasts for 14 years and after that, Weachter said, doctors
   can implant another one in the same chamber of the heart. They can
   repeat the procedure a third time if needed.

   The pacemaker activates only when necessary to keep the heart beating
   normally. [4]Studies show that the Micra and other leadless pacemakers
   are safe and effective.

   These tiny pacemakers are not right for all patients, but as the
   technology develops, more people will be able to benefit from the
   procedure. Four years after her implant, Trejo's doctors say she is
   doing fine.

References

   1. https://www.eurekalert.org/pub_releases/2014-05/tmsh-lps050914.php
   2. https://www.medicinenet.com/pacemaker/article.htm#pacemaker_definition_and_facts
   3. http://http://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/pacemakers/micra-pacing-system.html
   4. http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle&ID=2272332