March 28, 2023

Don’t Let the Size Fool You, this Device Packs a Big Punch

LMT D’Vino Special Heart Section

While more than 3 million people worldwide depend on their implanted cardiac pacemaker to regulate their heartbeat, 50 years after it was placed in its first patient, a new development—an upgrade if you will—has upped the ante with a more comfortable and sophisticated design that’s making waves among those with their pulse on cardiac care.

“A leadless pacemaker differs in two ways from the conventional pacemaker,” explained Dr. Ricardo Cigarroa, Interventional Cardiologist, “First, it does not require pacing wires, and second it’s implanted directly into the right lower chamber of the heart. Truly, a remarkable milestone for a device that has not seen much change in the last five decades.”

While the device is 90% smaller than the traditional pacemaker, Dr. Cigarroa says the small size shouldn’t fool you—it packs quite the punch for something that is no bigger than a .22 caliber bullet, and is changing how his patients feel about pacemakers.

“Prior to the leadless pacemaker, it was difficult to tell a patient they would wear a pacemaker for the rest of their life if they wanted to continue living,” said Dr. Cigarroa. “For some, just the mere thought of being able to see a device under their skin can cause one to defy logic in an attempt to convince themselves they don’t need a pacemaker. But that changed in 2016 when the leadless pacemaker became a viable option for many of my patients.”

The primary advantage of a leadless pacemaker is the elimination of several complications associated with traditional pacemakers and leads (wires). Some of these include pocket infections, hematoma, lead dislodgment, and lead fracture. For women, the leadless pacemaker also has cosmetic appeal because there is no chest incision or visible pacemaker pocket—a factor that peaked Ms. Irma de Jesus’ curiosity when her cardiologist, Dr. Cigarroa, first told her about the new pacemaker.

“When Dr. Cigarroa first told me I needed a pacemaker, I thought it was going to cause even more problems because I would always have to make sure I protected the area it would protrude from,” said Ms. de Jesus. “But when he showed me a leadless pacemaker and said I wouldn’t even know it was there, that convinced me to have the procedure done.”

When implanting a leadless pacemaker, Dr. Cigarroa places the pacemaker inside a catheter, then guides the catheter through a blood vessel near the patient’s groin until it reaches the lower chamber of the patient’s heart. The pacemaker is then moved out of the catheter and attached to heart tissue where it will remain with the patient never feeling any discomfort.

“The entire procedure takes less than 15 minutes,” said Dr. Cigarroa. “It’s incredibly sophisticated, but very simple to put into a patient, with very little recovery, if any.”

The battery life of a leadless pacemaker is approximately 5-15 years, comparable to that of a transvenous pacemaker. At end of battery life, a leadless pacemaker can be turned off and a new leadless or traditional pacemaker can be implanted.

“The leadless pacemaker changed my life,” said Ms. de Jesus. “For starters, I’m not constantly thinking about it, because I don’t ever feel it. On the contrary, I always feel perfectly fine, thank you to God.”

Dr. Cigarroa says not everyone qualifies for a leadless pacemaker, and those individuals who continue needing a traditional device, can rest assured it remains the standard of care in cardiology.