State’s first Micra AV pacemaker implant performed at Forrest General
This week at Forrest General Hospital, cardiologist Randel Smith, MD, performed the state’s first pacemaker implant using the new revolutionary Micra™ AV pacemaker. Smith was assisted by Diego Alcivar, MD, an electrophysiologist. Forrest General and University of Mississippi Medical Center are the only two hospitals that currently have this therapy.
“Technology has been very kind to us over the last 30 years,” said Alcivar. “And now we have the capacity to implant devices that are basically the size of a quarter. This device is less invasive than the devices we continue to use, which are placed in the top corner of the chest and puts wires inside the heart. You have a lot of hardware inside of your heart.”
Billed as the world’s smallest pacemaker, this new technology, referred to as “transformational,” may allow many more patients who need pacing to become candidates and receive that therapy from a leadless pacemaker. Until now, treatment with leadless pacing was appropriate in only about 10-15 percent of pacemaker cases.
“We at Hattiesburg Clinic, together with Forrest General, have been accepted to perform this brand new Micra AV technology,” Alcivar said.
The Micra AV is about the size of a large vitamin and is one-tenth the size of a traditional pacemaker. It is implanted inside the heart through the femoral vein in a minimally invasive procedure that takes 15 to 20 minutes. The Micra AV requires no wires or leads. When used, studies show a 63 percent reduction in complications as compared to traditional pacemakers, which require surgery to create a pocket in the upper chest for the battery and wires or leads run from the battery into the heart.
Alcivar noted that this technology is a great option for patients who had had infections or older patients who might not want to go through an extensive procedure.
“Most patients don’t even know they have a pacemaker, since it is cosmetically invisible” said John Chancellor, a representative for Medtronic, which manufactures the Micra device.
This Medtronic leadless pacing technology is now available to approximately half of all pacemaker patients in the United States and offers a host of potential benefits for patients.
Micra AV is for the treatment of patients with AV block, a type of heart block in which the electrical signals between the chambers of the heart (the atria and the ventricles) are impaired. Pacemakers, the most common way to treat AV block, help restore the heart's normal rhythm and relieve symptoms by coordinating the electrical activity of the atria and the ventricles. When this process – known as AV synchrony – is achieved, patients are healthier and have decreased likelihood of pacemaker syndrome, improved quality of life, and increased blood flow from the left ventricle.
The Forrest General patient received the implant on Wednesday and went home on Thursday.
This is not the first time Forrest General has been one of the first hospitals in the South to use innovative Micra technology. In July 2017, Smith, along with fellow cardiologist, Mark Borganelli, MD, performed a procedure using the Micra Transcatheter Pacing System (TPS), the Micra AV’s predecessor, for management of bradyarrhythmia or excessively slow heart rate, in a patient.
Cutline: Taking part in the state’s first pacemaker implant using the new revolutionary Micra™ AV pacemaker at Forrest General this week are, front row from left, Mark Borganelli, MD, cardiac electrophysiologist; Randel Smith, MD, cardiology; and Natalie Brown, RAD tech; back row, Clint Lambert, RAD tech; Pat Peterson, RAD tech; Diego Alcivar, MD, cardiac electrophysiologist; and John Chancellor, Medtronics representative.
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