An 87-year-old man who was brought to Sri Ramachandra Medical Centre with complaints of recurrent syncope and low pulse rate is now leading a normal life with the support of a miniature pacemaker.
The patient, who was diagnosed as suffering from bradycardia, a condition where the heart beats usually fewer than 60 beats per minute and can lead to fainting spells, also had blocked veins in the right and left shoulders.
Doctors had to hence implant a small pacemaker directly into the heart. “The device is small enough to be delivered through a catheter and implanted directly into the heart with small tines, providing a safe alternative to conventional pacemakers without the complications associated with leads — all the while being cosmetically invisible. The Micra TPS is also designed to automatically adjust pacing therapy based on a patient’s activity levels,” said cardiologist T.R. Muralidharan, who performed the procedure.
The micra transcatheter pacing system is a lead-less pacemaker recently approved by the United States Food and Drug Administration and is tenth of the size of a conventional pacemaker.
“The device will ensure that the heart beat does not go below 70 beats/minute,” Dr. Muralidharan said.
As to whether all elderly with complaints of slower pulse rate might require such a procedure, he said it was normal for the heart to slow down as a person aged but not every person with low pulse rate required a heart device. “We will evaluate the patient and only if it is an irreversible cause will it require the procedure,” he said.
The device, costing Rs. 8 lakh, was implanted five days after admission. The octagenarian was discharged another five days later.
“We watched him for a month. He has recovered well and can carry out his normal activities like any retired person,” the doctor said. The device is designed so that it can be permanently turned off to allow implanting a new device without the risk of electrical interaction. The patient will also be able to undergo a full-body MRI scan if necessary, according to a hospital release.
