World's Smallest Pacemaker Now Offered at Mercy General Hospital

Every year in the United States, doctors implant about 200,000 pacemakers. Most often, they are used to treat people with a condition called bradycardia, a type of arrhythmia in which the heart beats too slowly.

This year, Dignity Health Mercy General Hospital began using the world's smallest pacemaker to treat people with this condition. It is the first hospital in Sacramento and among the first in California to use this new technology. The Micra transcatheter pacing system (TPS) is a big advancement for patients who meet specific criteria for the device.

How Do Pacemakers Treat Bradycardia?

In people with bradycardia, their heart rate is less than 60 beats per minute. This can mean that your heart isn't sending enough oxygen-rich blood throughout your body. It's most common in older adults and causes dizziness, shortness of breath, fatigue, and fainting.

Your heart receives electrical signals from the sinoatrial node. If those signals are too slow or interrupted, your heart doesn't beat properly. A pacemaker is a device implanted under the skin that sends electrical impulses, telling your heart to pump at a normal pace.

What Are the Advantages of the Micra TPS?

The Micra TPS offers many advantages for patients who qualify for the technology. Measuring about the length of your fingertip, it's significantly smaller than any other pacemaker. Most newer pacemakers weigh less than an ounce, but the Micra TPS weighs about 0.06 grams.

Its size isn't the only advantage. A traditional pacemaker consists of a small generator, about the size of a wristwatch, implanted under the collarbone. Cardiac wires, called leads, are inserted into a vein and into your heart. Although pacemakers are relatively safe, complications that do arise are most often because of problems with the leads.

The Micra TPS has no leads. It is inserted through a catheter into the heart, and it has tines that hold it in place. The device has 48 percent fewer major complications than traditional pacemakers.

Most people with a pacemaker are able to return to normal activities, including exercise. The Micra TPS adjusts the pacing of electrical signals based on your physical activity level, allowing your heart to keep up with you.

Other advantages include:

• Contact with your doctor. The pacemaker sends information to your doctor through the Medtronic CareLink Network.

• Easy retrieval feature. The device is designed to be permanently implanted; however, if it needs to be removed for any reason, the device is also designed for easy removal.

• Safe for another device. Sometimes people need to have more than one heart device. Your doctor can turn off the Micra TPS and leave it in your body so another device can be implanted without electrical interference.

• Safe for MRI. Some pacemakers have limitations with magnetic resonance imaging. You can safely undergo a 1.5 Tesla or 3 Tesla MRI with the Micra TPS. It's currently the only pacemaker approved for both imaging systems.

The federal Food and Drug Administration approved the Micra TPS for use in 2016, and Mark Bowers, MD performed the first procedure with this device at Mercy General Hospital in July 2017. Medicare will also reimburse for the world's smallest pacemaker, allowing wider access to this advanced technology. However, it's important to keep in mind that this device costs significantly more than a regular pacemaker and there isn't any extra reimbursement.