Leadless pacemakers

Leadless

by Theknotguy - 2020-03-03 10:36:28

Pacemakers directly implanted into the heart were introduced in Europe and England because they don't have the government overseers we have in the USA.  After several years being used in the European area they were finally approved in the United States.  

There isn't too much discussion about them because after they're implanted there isn't too much you can do.  Also, people with the leadless pacemakers usually have fewer heart problems than those needing the larger units with leads.  

Discussion I had with my EP was that I didn't qualify for a leadless pacemaker - and they weren't out at the time.   

Discussion with a pacemaker tech was, life of the leadless pacemakers is supposedly 10 - 15 years.  They don't remove the units after the battery runs down, just implant a new one.  You can have up to three units implanted so theoretically that means you can go up to 45 years before they have to figure out what they will do at that time.  And, since they haven't been out for 45 years, no one knows what will happen.  Also assume they would have to implant one of the full sized units with the leads if you develop further heart problems.  So there are a lot of unknowns with the in-the-heart type of pacemakers.  

Other questions are about how your body reacts.  I had a blood clot in my heart and it felt like someone had stuck a fork in the middle of my back.  So I don't know how I would react to having something in my heart.  Would I feel it all the time?  Next question is what they can do if there is a problem with the unit.  Current surgery on the full sized units is to open the pocket and quickly exchange for a new one.  Going into the heart is a much more difficult proposition.  So, as I said before, there are a lot of unknowns with the in-the-heart type of pacemakers.  
 

Get as much info as you can

by nhorner10 - 2020-03-03 15:00:46

I too was very interested in the Micra before I had my PM placed last August - I'm an active 24 year old and the the Micra, being leadless and all around less noticeable, was a very attractive choice. However, these are a lot newer than the traditional PMs and as such there are a lot more unknowns. It's definitiely a conversation to have with your doc, but these were my main reasons for going with a traditional PM with leads.

1.  As theknotguy points out, (as of now) they don't really remove the Micra after it dies, they just put in another one. Being a young guy, I've got a lot of time left with this thing and I don't really want anymore hardwear in my body than is necessary.

2. There was some question about whether the Micra would even be an effective choice for me. The Micra is inserted into the right ventricle and paces the AV node (makes sure your ventricle is beating in sync with your atrium - basically your heartbeat starts in the SA node in your atrium and travels down to your AV node in your ventricle). If the problem is something involving your SA node or really anthting other than a ventricle beat timing issue (so basically most issues), the Micra might not be the best choice. 

3. The Micra just hasn't been around as long and I wanted something with a proven track record of being effective.

These are just my opinions/perceptions on the matter. Again, it's a conversation to have with your doctor as I am NOT one. In the end it really comes down to the individual and their specific condition/needs. Hope this helps!

https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=sts14215&lang=en-ca

Leadless Pacemaker Removal

by AgentX86 - 2020-03-03 16:11:39

The need for the removal of leadless pacemakers is a known problem and is being actively worked on.

<https://cardiacrhythmnews.com/what-we-know-about-retrieval-of-leadless-pacemakers/>

As noted above, a leadless pacemaker is only useful in a fairly small subset of pacemaker patients. They're getting better but have a long way to go.