Cape Town - Groote Schuur Hospital has made history by becoming the first hospital in Africa and the Middle East to implant the world’s smallest pacemaker – the size of a tablet.
The Micra Transcather Pacing System, also known as a Medtronic Micra, which is being tested globally as part of a clinical trial, has since been inserted in three city patients – all over 60 years old.
Dr Ashley Chin, a consultant cardiologist and electrophysiologist at Groote Schuur and UCT Private Academic Hospital, successfully performed the procedures in March.
He explained that while a conventional pacemaker is implanted in the chest through surgical incision and the creation of a “pocket” under the skin, the new technology is inserted through a blood vessel. The new procedure eliminates any visible sign of the device, he said.
According to Chin, the new pacemaker, which is one-tenth the size of a conventional pacemaker, and comparable in size to a large vitamin pill, is inserted through a small skin incision (1cm long) in the groin area.
The pacemaker is then advanced up the main vein in the upper leg artery and delivered to the right ventricle of the heart.
Once positioned, the pacemaker is securely attached to the heart wall and can be repositioned if needed. The miniature device does not require the use of wires, or leads, to connect to the heart. Rather it is attached by small tines.
It then delivers electrical impulses that pace the heart through an electrode.
Chin said the main benefit of the device was that it was a “leadless” system. Its battery life was estimated at about 10 years.
“So all the potential complications from conventional pacing leads do not exist like lead fracture, infection and so on. This miniaturised technology is designed to provide patients with the advanced pacing technology of traditional pacemakers via a minimally invasive approach,” he said.
Groote Schuur Hospital, which was chosen to be one of 30 centres around the world to implant the leadless pacemaker as part of a clinical trial, is the only centre in Africa and the Middle East to test the device.
Chin said he was proud that the hospital was selected among an elite group of institutions to take part in the study.
“If positive, the results of the trial could potentially benefit more than 1 million people globally who receive pacemakers each year,” he said.
The device, which has already been certified in Europe, would probably be available commercially in under two years’ time.
Cape Argus