New leadless St. Jude PM

I recently heard about the leadless St. Jude PM that goes directly in the heart with no wires in veins. The rep from St. Jude was at my doctor's office when I was there in PM lab for a routine check up and she told me about it. I have about 8 years left on mine but an acquaintance, only 34, was told she needs a PM for SSS like I have. Does anybody out there know how safe the new ones are and when they will be available?

2 Comments

Nanostim

by golden_snitch - 2014-07-13 03:07:15

Hi!

My EP has been implanting a few already, his department is one of the few in Europe allowed to do the procedure. But at the moment the St. Jude Nanostim is only implanted in elderly patients, with low activity levels, who are not pacemaker dependent, and who are fine with a single-chamber, ventricular pacemaker. So, basically only patients whose heart rate drops a little too low every now or then due to sinus brady or a heart block. What puzzles me a bit is that it's only implanted in the right ventricle at the moment, and someone with sinus brady should rather be paced in the right atrium; that would be optimal, but of course ventricular pacing works, too. Also, I think, the Nanostim is not rate responsive (yet), which is why it's given to patients with a low level of activity; it cannot adjust the heart rate to physical exercise. My EP said that maybe in 10-15 years a device like this, placed inside the heart, will be available for me, too. I have a much more complex rhythm issue, with SA and AV-node ablated, rate response needed, and so on. We'll see.

Here are the indications St. Jude names:
- Chronic atrial fibrillation with 2 or 3 degree AV or bifascicular bundle branch block (BBB),
- Normal sinus rhythm with 2 or 3 degree AV or BBB block and a low level of physical activity or short expected lifespan, or
- Sinus bradycardia with infrequent pauses or unexplained syncope with EP findings.

Many of us here do not fit these. I guess in a couple of years, the Nanostim will be available for a broader range of indications. Medtronic is testing a similar device, called the "Micra", humans, too. It has a different shape than the Nanostim, I think it's even smaller.

Inga

Helpful Information

by boochance - 2014-07-13 04:07:34

Thanks inga.. I was jumping the gun thinking this new leadless PM would be available soon to most of us. Oh well, back to being thankful for the PM I have.

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I am 100% pacemaker dependant and have been all my life. I try not to think about how a little metal box keeps me alive - it would drive me crazy. So I lead a very active life.