Micro device

I have a medronic pacer for rate drop. Installed 2009 and it's still working although they keep saying 1 to2 years left. I'm hoping eventually they'll switch  to a micro device that's not visible.  The one I have is big.. anyone know if a micro would be suitable?

Also if so, how is the process to remove the old style and put in the micro device?



by Tracey_E - 2023-09-19 12:20:25

There are currently two leadless on the market. Micra is Medtronic and has been around longer. To get dual chamber pacing with Micra, they use two devices- one in the atria and one in the ventricle. Not ideal, my doctor is not a fan of this in patients who are younger and will be paced for a lot of years because Micra is not designed to be removed. They simply add a new one.

Abbott has one for dual chamber pacing that just received FDA approval in July so it's very new. It's one device that will pace both chambers. It is designed to be removed when they place a new one. The first person in the UK to get one without removing existing leads first just got it about two weeks ago so this is very very new.  Previously people were only candidates for leadless if they needed single chamber, did not have existing traditional leads, and were not dependent. Most of us here don't qualify on any of those counts but that is changing rapidly. I've got a little over a year on my current device and a failing 30 year old lead so  I'm watching this closely! I posted last week after I saw my ep. He said we can consider the Abbott, but he wants to watch how it goes over the next year and do more research, but it may be an option. 

Leads can be extracted, yes. The older they are, the harder it is to get them out. Technology has come a long way in the last ten years and there are now quite a few experienced specialists, so if you end up extracting be sure to find one of them. Don't let just anyone do it. They go in with a catheter and laser and remove the old leads mm by mm. 

Are your leads still in good shape? If yes, they will probably want to keep using them for now and simply replace the box. Ask if you can have a smaller one, or if they can bury it a bit deeper. JMHO, don't extract unless you have a compelling reason to do it. It's not as dangerous as it used to be but it's still a serious and complicated surgery if you have very old leads. 


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