- The patient had an occluded upper venous vascular system, so implantation of a conventional pacemaker via this route could not be performed.
- The leadless pacemaker is placed directly into the heart without the need for a surgical pocket or pacing wires, thereby reducing the risk of complications.
The Ribera Povisa Hospital has successfully implanted its first leadless pacemaker in a patient who did not have access to the heart through the upper venous system. This is a device that also allows the elimination of complications related to the manipulation of the cables for their connection and represents an improvement due to its reduced size and the elimination of the subcutaneous pocket where conventional pacemakers are placed.
Dr. Luis González Torres, from the Cardiology Unit of the Ribera Povisa hospital, headed by Dr. Emad Abuassi Alnakeeb, has implanted this first device in a patient admitted to the Vigo health centre for symptoms related to low heart rate, but who had the venous vascular system of the upper part of the body occluded, meaning there was no access to the heart in this way.
“Our patient required the implantation of a pacemaker using wires implanted through the subclavian vein, which is located in the upper part of the body. However, the venous system in that part was occluded,” explains the specialist.
“Thanks to this new technology of leadless pacemakers, it was possible to solve the patient's pathology by implanting this small pacemaker through the vein in the leg,” adds Dr. González.
The leadless pacemaker offers a minimally invasive option as it is implanted through the femoral vein with a steerable catheter, so neither the surgical pocket nor the leads are necessary, reducing the overall incidence of complications by about 50%.
Conventional pacemakers are implantable devices used to treat people with certain heart rhythm disorders. “To place them, a surgical procedure is required, which consists of implanting an electrical impulse generator (battery) and an intravenous electrode cable. One end of the electrode is placed on the inner wall of the heart and the other end is connected to the generator,” explains cardiologist Emad Abuassi Alnakeeb, head of the Cardiology service at the Ribera Povisa Hospital.
These types of pacemakers require the doctor to make a surgical incision in the chest, where the pacemaker is placed in a 'pocket' that forms under the skin, permanently. The doctor then implants the pacemaker wires through the veins until they reach the heart.
Wireless and 93% smaller
Leadless pacemakers, which are placed directly into the heart without the need for a surgical pocket or pacing wires, reduce the risk of complications.
This device, designed by Medtronic, is 93% smaller than a conventional pacemaker, measuring about 2,5 centimetres, with a volume of 0,8 cubic centimetres and weighing only 2 grams. It consists of an impulse generator that includes a battery and an electrode that sends impulses to the heart when it detects a problem with the heart rhythm, and has anchors that serve to fix it to the wall of the right ventricle.
In addition, it increases patient satisfaction because it leaves no scars or lumps under the skin.