What makes leadless pacemakers a game-changer in the world of pacemakers
Recently, a patient named Bimal Tiwari from Navi Mumbai was diagnosed with Bradycardia, a condition marked by slow or irregular heart rhythms, typically fewer than 60 beats a minute as against the normal range of 60-100bpm. As a result his heart struggled to pump enough oxygen rich blood, leading to Tiwari experiencing dizziness and a loss of balance.
As per the doctors at Medicover Hospital whom Tiwari consulted, implanting a pacemaker was the only solution to restore the normal functioning of his heart impulses before the condition could deteriorate to complete blockage.
The pacemaker is the most common and effective treatment for Bradycardia and Degenerative CHB, helping to restore a normal heart rhythm and alleviate symptoms.
While a coronary angiography and pacemaker implantation could have easily been done in Tiwari's case, restoring stability, it turned out that an invasive procedure such as the conventional pacemaker implantation could become too risky and life threatening for him as he was also diagnosed with "severe thrombocytopenia," that is a sign of having a high chance of bleeding complications.
Given the high surgical risks, conventional pacemaker implantation wasn’t possible. At the time, doctors at the hospital suggested the 'leadless pacemaker' to be the safest and most advanced option for the patient, offering an effective solution for managing bradycardia (slow heart rate)."
"This minimally invasive device is implanted directly into the heart, eliminating the need for leads or surgical incisions, thereby reducing complications and ensuring a faster recovery. Leadless pacemakers are advanced devices that automatically regulate heart rate without the need for surgery, batteries, or leads like conventional pacemakers. Instead, they are implanted directly into the right lower heart chamber using catheters. Since they do not require a surgical pocket or leads, they offer a safer alternative with a lower risk of bleeding, complications, and infections. The patient regains mobility immediately after the procedure, requiring minimal post-operative care. The procedure, performed in the cath lab, took approximately two hours and was completed without anesthesia," said Dr Keshav Kale, Senior Interventional Cardiologist, Medicover Hospital, who operated on the patient.
Cardiovascular surgeons are of the opinion that leadless pacemakers are a recent game-changer in the world of pacemakers. Over the years, ever since the technology was first put to use in the 1950s, permanent pacemakers have undergone rapid advancements, with improvements to reduce generator size, increase battery life and quality, among others. In a paper titled, 'Leadless Pacemakers: Current Achievements and Future Perspectives,' published in the 'European Cardiology Review,' authors call the transvenous implanted leads "the Achilles’ heel of this rhythm-control therapy."
Calling the leadless permanent pacemaker system a "disruptive and promising technology," they write that with the advances in battery technology and deep miniaturisation of electronics now offers the opportunity to implant the whole pacemaker system into the right ventricle.
While admitting that the advent of battery-less leadless pacemakers has opened new frontiers, they warn that further research is required before some of these technologies are safely and routinely used in clinical practice.
"We predict that leadless cardiac devices will see significant growth and development over the next decade," note the authors of the study.
What's more? In addition to single-heart-chamber ventricular leadless pacemaker there is the "dual-chamber leadless pacemaker system consisting of two devices implanted percutaneously, one in the right atrium and one in the right ventricle, that makes leadless pacemaker therapy a treatment option for a wider range of indications," says a report published in the New England Journal of Medicine.
Here's is how leadless pacemakers compare with other conventional pacemakers, as per experts and available research available in academic journals :
1. Less invasive implantation: Leadless pacemakers are implanted directly into the heart through a vein in the leg, eliminating the need for a chest incision and scar.
2. Reduced risk of complications: Leadless pacemakers have a lower risk of complications such as lead fracture, insulation breach, and pocket infections.
3. Smaller size: Leadless pacemakers are significantly smaller than traditional pacemakers, making them less noticeable and more comfortable for patients. They are the size of a large vitamin capsule.
4. MRI compatibility: Leadless pacemakers are designed to be MRI-compatible, allowing patients to safely undergo magnetic resonance imaging scans.
5. Fewer interventions post installation: Leadless pacemakers have been shown to require fewer re-interventions compared to traditional pacemakers.
6. Improved patient comfort: Leadless pacemakers eliminate the need for a chest pocket and lead, which can cause discomfort and restrict patient movement.
7. Reduced risk of infection: Leadless pacemakers have a lower risk of infection compared to traditional pacemakers, as there is no lead or pocket that can become infected.
8. Longer battery life: Leadless pacemakers have a longer battery life compared to traditional pacemakers, with some models lasting up to 13 years.
9. Automatic heart rate adjustment: These leadless pacemakers can adjust the heart rate automatically based on the patient's activity levels
Health