WATCH: A first for KZN as surgeons insert world’s tiniest, leadless pacemaker into patient’s heart

Published Oct 12, 2022

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Durban – In what can only be described as a revolutionary moment in medical history, KwaZulu-Natal cardiologist and electrophysiologist Dr Brian Vezi inserted the world's tiniest, leadless pacemaker into a man's heart at the Lenmed Ethekwini Hospital and Heart Centre this week.

Under the proctorship of cardiologist and electrophysiologist Professor Ashley Chin, Vezi successfully implanted the minute Micra pacemaker into a 60-something-year-old man's heart.

Micra leaves no bump under the skin like older pacemakers.

The Micra is 93% smaller than older pacemaker devices and has a battery life of 8 – 13 years. It is implanted through a vein using a catheter inserted in the patient's groin which drastically reduces scarring and patient's recovery time.

Traditionally, pacemakers are implanted through an incision in the upper chest. A surgeon inserts an insulated wire, known as a lead, into through the vein and into the heart before the device is connected and programmed. Once placed beneath the skin, the doctor tests the pacemaker and when it is functioning correctly, the incision is closed.

With the Micra, the device is inserted via a catheter through the upper leg and once the catheter system moves the Micra into the right ventricle of the heart, it is placed against the heart wall, secured with flexible tines, tested to ensure it's fully operational and the catheter system removed.

Speaking after the surgery, Chin said they were pleased with the result.

“This will be the way to go when treating certain patients. Obviously we have to still select patients properly for this kind of procedure. But at this point in time, it means that those patients who could not have these devices will be able to get them,” added Vezi.

He said while the Micra served the same purpose as older pacemakers, it is leadless and looks better aesthetically.

“It also helps in combating infection, which was an issue in this particular patient so he is less likely to have infection with the Micra. It can also help with other patients with poor venous access, particularly patients on chronic dialysis where another procedure is not a possibility, then this device is the best option,” Vezi explained.

“This means a lot to us as it is in line with our vision to be the leading health-care facility in KZN. Together with our accreditation from the American College of Cardiology that we have just received, the only hospital on the African continent (to be accredited), we are extremely proud to have a medical first for the province, performed at our facility,” said Lenmed Ethekwini Hospital and Heart Centre CEO Niresh Bechan.

He added that Lenmed was always looking at ways to expand its cardiac treatment options.

“Innovation and technology is something that we regard very highly on our agenda,” Bechan said.

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