World’s Smallest Pacemaker: Micra Transcatheter Pacing System (TPS)

World’s Smallest Pacemaker: Micra Transcatheter Pacing System (TPS)

The heart’s rhythm is a crucial part of one’s overall health. If it beats too fast, too slow, or experiences pauses in between beats, intervention is required to get it back on track.

In the case of a heart beating too slowly, a pacemaker is a viable treatment option.

“What many people don’t understand is that a pacemaker will correct all rhythm disorders, such as palpations and irregularities. It’s not going to correct those problems,” clarifies Dr. Brad Suprenant, an electrophysiologist with Riverside Medical Group. “A pacemaker only prevents the heart rate from going too slow.”

Advancements in Pacemaker Technology

As with other medical breakthroughs, there has been significant advancements in pacemaker technology. The type and size of pacemakers, how they’re implanted, and the breadth of diagnostics have all evolved. Gone are the days where an invasive surgery was required. Rather, devices are inserted percutaneously through the skin and implanted through a vein.

Even more advanced is the Micra transcatheter pacing system (TPS), which has been termed the world’s smallest pacemaker. “This system is cosmetically invisible—it’s like a small pellet that goes into the heart, similar to the size of a large vitamin,” explains Dr. Suprenant.

Thanks to technology’s progress, the previous issue of avoiding MRI scans has also been alleviated in most cases.

Candidates for TPS

The ideal candidate for TPS is someone who only needs single-chamber pacing. These patients regularly experience dizziness or lightheadedness due to a lag in heartbeat. While young people occasionally require a pacemaker, Dr. Suprenant cites the mature and elderly populations as the most common groups to receive this intervention.

Symptoms & Diagnosis

Typically, a patient will first recognize something is amiss when certain symptoms arise, such as feeling faint, blacking out, or suffering extreme dizziness. Primary care physicians often do a cursory workup and then refer to a cardiologist if deemed necessary.

The time from diagnosis to pacemaker insertion varies, depending on how long the diagnostic process takes. “Sometimes, the process is quite quick and straightforward. Other times, long-term monitoring is needed to definitively determine the reason for symptoms,” states Dr. Suprenant.

Returning to Life as One Knows It

Procedures to place a pacemaker—whether the TPS or not—are semi-invasive, but Dr. Supernant believes the benefits to one’s overall health and lifestyle are well worth it.

Again, surgeries that previously required weeks-long stays in the hospital are a thing of the past. Patients who undergo a pacemaker implantation typically go home the next day; sometimes even the same day.

“We advise patients to take it easy for a few weeks while the incision mends and to ensure leads do not dislodge from the heart, but beyond that, their activity level can be the same once fully healed,” says Dr. Supernant. “We encourage all patients to resume—and maintain—a healthy, active lifestyle.”

To learn more about the Micra transcatheter pacing system and the cardiology department at Riverside Medical Group, visit