Leadless Pacemaker
What is a Leadless Pacemaker?
A leadless pacemaker is a tiny, self-contained cardiac device implanted directly into the heart via a vein in the leg. These devices are around 10 times smaller than traditional pacemakers—just a bit longer than an average medication capsule—and do not require leads (pacing wires) or a surgical pocket in the chest.
Unlike traditional pacemakers, which involve a battery under the collarbone and wires into the heart, leadless pacemakers sit entirely within the heart itself. They can be implanted in either the atrium or the ventricle as a single unit or used in combination for dual-chamber pacing, where two devices communicate wirelessly to support both chambers.
Who Might Need a Leadless Pacemaker?
Your doctor may recommend a leadless pacemaker if you:
- Have a slow heart rate (bradycardia)
- Have had complications with a previous pacemaker
- Are at increased risk of infection
- Have limited access through your veins for pacemaker wires
Would prefer a minimally invasive option without a visible scar or lump on the chest
Leadless pacemakers are not suitable for everyone. Your QCG cardiologist will assess your condition and medical history to determine if this type of device is appropriate.
Benefits of a Leadless Pacemaker, Compared to Traditional Pacemakers
There are several advantages that may lead to a leadless pacemaker being recommended for you.
- No wires or battery in the chest
- Less invasive procedure with smaller incision (via groin)
- Reduced risk of infection or lead-related complications
- No scar or visible lump on the chest
- No restrictions on arm movement post-surgery
- Shorter hospital stays and faster recovery
- Battery life of up to 15 years
- MRI compatible
Types of Leadless Pacemakers
Abbott AVEIRâ„¢ Leadless Pacemaker
- Single and Dual-Chamber Options: The AVEIRâ„¢ system includes both single-chamber (ventricular) and dual-chamber (atrial and ventricular) pacing options. The dual-chamber system utilizes Abbott’s i2iâ„¢ technology, allowing the two devices to communicate and coordinate pacing between the heart’s chambers.
- Size and Design: The AVEIRâ„¢ VR leadless pacemaker measures approximately 38 mm in length and is designed for secure implantation within the heart.
Medtronic Micraâ„¢ Leadless Pacemaker
- Micraâ„¢ VR2 and AV2: Medtronic offers the Micraâ„¢ VR2 for single-chamber ventricular pacing and the Micraâ„¢ AV2, which provides atrioventricular (AV) synchrony for patients requiring dual-chamber pacing.
- Compact Size: The Micraâ„¢ device is about 25.9 mm in length and 6.7 mm in diameter, making it 93% smaller than traditional pacemakers.
How to Prepare for a Leadless Pacemaker Implantation Procedure
Prior to the procedure:
- Consultation: You will have the opportunity to ask questions and discuss any concerns with your cardiologist.
- Fasting: You may be required to fast for 6 to 8 hours before the procedure.
- Hospital Admission: You will be admitted to the hospital on the day of your procedure.
- Pre-Procedure Tests: Blood tests and an electrocardiogram (ECG) may be performed.
- Preparation: The insertion site (typically the right groin) will be shaved and cleaned, and an intravenous (IV) line will be established.
What Happens During a Leadless Pacemaker Implantation Procedure
The procedure is performed in hospital, typically under local anaesthetic with light sedation for comfort. A thin tube (catheter) is inserted through a vein in the leg and then guided to your heart, where the pacemaker is carefully positioned and secured. The device is tested, and the catheter is then removed.
The entire process usually takes about 60 to 90 minutes. Most patients return home the same day or after a brief hospital stay.
What Happens After the Leadless Pacemaker Implantation Procedure
- Monitoring: After the procedure, you will be taken to a recovery area where your heart rhythm and vital signs will be monitored.
- Hospital Stay: Most patients can expect a short hospital stay, usually being discharged the next day.
- Follow-Up: You will have follow-up appointments to monitor the pacemaker’s function and battery life. Adjustments to the device programming can be made in a normal consultation using a device programmer – this is a computer system that uses a handheld magnet to wirelessly communicate with the device.
- Identification Card: You will receive a pacemaker identification card with details about your device, which should be carried at all times.
Returning to Daily Life
- Activity: Most patients can resume normal activities, including work and light exercise within a few days, as advised by your doctor.Â
- Device Interference: Leadless pacemakers are designed to minimise interference with electronic devices.
- MRI Scans: Both Abbott and Medtronic leadless pacemakers are designed to be safe for MRI scans under specific conditions. Always inform medical personnel about your pacemaker before undergoing any procedures.
- Airport Security: Airport screening equipment may detect the pacemaker’s metal case. Present your pacemaker identification card to obtain clearance. Airport screening equipment will not harm your pacemaker.
Frequently Asked Questions About AFib Symptoms
Yes. It is safe to fly with a leadless pacemaker. Airport security systems may detect the device, so carry your pacemaker identification card and inform security personnel.
Leadless pacemakers have an estimated battery life of up to 15 years, depending on individual usage and device settings.
Yes. Both Abbott and Medtronic leadless pacemakers are MRI-compatible under specific conditions. Always inform your healthcare provider about your device before undergoing an MRI.
Most patients can resume normal activities shortly after the procedure. Your doctor will provide specific guidance based on your individual condition.
No. Leadless pacemakers are implanted directly into the heart and do not leave a visible scar or lump on the chest.
References:
- Abbott AVEIRâ„¢ Leadless Pacemaker Patient Brochure.
- Medtronic Micraâ„¢ Leadless Pacemaker Patient Information.
- Abbott AVEIRâ„¢ Leadless Pacemaker MRI-Ready Leadless System Manual.
