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World’s smallest and lightest leadless pacemaker MICRA implanted at Fortis Malar Hospital

Chennai, January 2019: Doctors at Fortis Malar Hospital successfully implanted world’s smallest and lightest leadless pacemaker MICRA on a 31-year lady here recently. The patientwas suffering fromcomplex congenital heart disease and very altered cardiovascular anatomy.  The challenging procedure was conducted by a team of expert doctors led by Dr E Babu, Consultant Heart Failure & Interventional Cardiologist, Fortis Malar Hospital, Chennai.

Commenting on the procedure Dr E Babu, said “This procedure was particularly challenging due to the altered anatomy and septal defects. The uniqueness of this case is MICRA catheter has been manipulated via transfemoral approach and deployed successfully in RV septum in this underweight patient with complex congenital heart disease.”

The patient was diagnosed with complex cyanotic congenital heart disease (complete atrioventricular canal defect with Eisenmenger syndrome), and later developed atrial tachyarrhythmiaand complete heart block with low ventricular rate. As she was not suitable for corrective surgery, she was advised single chamber permanent pacemaker implantation and eventually MICRA leadless pacemaker was decided.

Dr E Babu added “The function of a pacemaker is to increase the heart rate when it is low. Conventional pacemaker has to two parts namely the pulse generator (generator) and the lead. This pulse generator is implanted beneath the skin in upper chest wall through a mini surgical procedure and a long lead connects it to heart. This requires 3-7 days of hospital stay, removal of stitches after 1 week and may be associated with issues of infection, wound healing, etc. On the other hand, MICRA pacemaker procedure is a percutaneous procedure just like undergoing angiography; cosmetically good because there is no scar in the chest wall; patient can be mobilised on the same day and may be performed as day-care procedure in straightforward cases.”

MICRA pacemaker is the world’s smallest and lightest leadless cardiac pacemaker currently available. It is delivered percutaneously via transfemoral venous approach through a catheter and implanted directly in the right ventricle. MICRA is a single chamber pacemaker; it is the pulse generator and does not require the use of leads. MICRA is 93% smaller (25.9×6.7mm) and also lighter (1.75g) than conventional pacemaker, with an average battery longevity of 12-years and MRI compatibility. It is just the size of a large tablet/capsule. It has >99% higher implant success rate and 63% fewer long-term complications (primarily) than conventional pacemaker.

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