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AHS cardiologists think big … and small

December 10, 2014

World’s tiniest pacemaker offers huge benefits

Story and Photo by Colin Zak

Looking at Victor Bohonos Orist, you would never guess he has a pacemaker.

Without the bulky battery pack protruding from underneath his skin, he bears none of the visible signs of patients with traditional heart rhythm monitoring devices.

“The device is so small, I forget it’s even there,” says the 87-year-old Calgary man.

Orist was the first of eight patients who have been implanted with the world’s smallest pacemaker at Foothills Medical Centre.

The device, which is about an inch long, is a fraction of the size of traditional pacemakers and doesn’t have external cords or an external power source. It offers shorter recovery times and a lower risk of infection for patients with heart rhythm disorders.

“The first thing I asked was when I could start playing golf again. They told me as soon as I could schedule a tee time,” says Orist, who had the device implanted in September.

Unlike traditional pacemakers – which are visible under the skin near the collarbone with electrodes or leads connected to the heart through veins – the electrodes and battery are all contained within the new, smaller device. Calgary is one 55 centres worldwide, including three in Canada, participating in an international study evaluating these devices.

“This miniature pacemaker can be easily implanted via a minimally invasive procedure. Once implanted, patients are barely aware it’s there,” says Dr. Derek Exner, a heart rhythm specialist and researcher with Alberta Health Services (AHS) and the Libin Cardiovascular Institute of Alberta at the University of Calgary’s Cumming School of Medicine.

Heart arrhythmias or rhythm disorders are extremely common and reducing the size of pacemakers can have a tremendous benefit to a patient’s quality of life.”

Pacemakers provide heartbeats and regularize heart rhythm. More than 200,000 Canadians are living with pacemakers, which can extend a patient’s life and also improve the quality of life.

“Patients have a faster recovery with this new device – one week compared to four – and there is less chance of infection or device problems since it is a single, integrated unit,” Dr. Exner says. “When the study is complete in two to three years, we expect these new devices will become more widely available and used commonly in patients needing pacemakers.”

The device, which is shaped like the tip of a pen, is inserted through a small incision in the groin and guided by X-rays into the right lower heart chamber. The entire procedure takes less than an hour and the device is expected to last up to 10 years.

“Providing the world’s smallest pacemaker to patients right here in Alberta shows once again that we are a Canadian leader in health research and innovation,” says Stephen Mandel, Minister of Health. “I am very proud of the advancements we make in health care – advancements that improve the health and quality of life of Albertans. I commend the team at the Foothills Medical Centre for their research and their commitment to improving patient care.”

Dr. Todd Anderson, Director of the Libin Cardiovascular Institute and a University of Calgary researcher, says smaller devices and minimally invasive procedures are improving patient outcomes and changing the way patients with heart rhythm conditions receive care.

“Libin’s cardiologists and cardiac surgeons have a reputation for performing the most innovative and forward-thinking procedures. This new mini-pacemaker is one more example of that,” Dr. Anderson says.

“For patients, this translates into better health and better quality of life.”