Is the New, Smaller Pacemaker Right for You?

Rashba Eric Rashba, MD
Director, Heart Rhythm Center
Stony Brook University Heart Institute

Many people have heart rhythm disorders, which means that instead of beating at a regular, predictable pace, the heart beats too fast, too slow or it stalls. These disorders are often caused by a problem in the heart’s electrical system. Slow heart rhythms may be treated with pacemakers to make the heart beat correctly. Now, for people with one type of rhythm disorder called “bradycardia,” Stony Brook University Heart Institute is using MicraTM, a revolutionary new type of pacemaker. Eric J. Rashba, MD, Director of the Heart Rhythm Center at Stony Brook Heart Institute, explains.

What is bradycardia?
Bradycardia, also called slow heart rate, is when the heart beats at 60 times a minute or less. For some people, a heart rate that slow can mean that the heart isn’t pumping enough oxygen-rich blood to the body. So even daily activities or light exercise can cause weakness, fatigue, shortness of breath or fainting. Not everyone with a slow heart rate needs a pacemaker — the presence of symptoms and the type of rhythm disorder are key.

What is the Micra pacemaker?
Micra is the newest generation of pacemakers for the treatment of bradycardia. It’s only for people whose slow heart rate can be treated with a pacemaker in just one of the four heart chambers. It cannot be used if a two-chamber pacemaker is needed. Micra is 93 percent smaller than traditional pacemakers, and unlike traditional pacemakers, Micra is a single unit that fits entirely inside the heart chamber. Everything needed to help regulate the heart rhythm is inside the Micra pacemaker. There is nothing embedded under the skin on the patient’s chest, and there are no wires connecting the heart to an outside pacemaker. Micra cannot be felt by the patient when it’s in position.

How does Micra work? 
A heartbeat is caused when the heart’s electrical system creates pulsing within the cardiac muscle. If the heart’s internal electrical system isn’t keeping the heart rate at a normal pace, the Micra pacemaker sends an electric impulse to normalize the rhythm and ease a patient’s symptoms.

Does Micra cure bradycardia?
The underlying heart rhythm disorder is still present. However, Micra will make the heart beat normally, so the patient will feel much better. Symptoms such as fatigue, weakness and breathlessness will likely be less frequent and less severe.

How is the Micra pacemaker implanted? 
The implantation procedure takes less than an hour. With the patient under sedation, we insert a catheter — a flexible, hollow tube — into the right femoral vein through an incision in the groin. We then thread the catheter, which is carrying the Micra device, up to the right ventricle of the heart. Using sophisticated imaging that lets us see real-time moving images of the heart chamber, we attach the Micra pacemaker to the heart muscle inside the chamber. The catheter is then removed, and the small incision in the groin is stitched closed.

Why is Stony Brook a good place for getting a pacemaker? 
Putting a device inside a person’s heart requires a lot of precision and skill. Our cardiologists have been trained in how to properly insert and position Micra, and are fully credentialed to perform the procedure. Even more importantly, we have many patients who are now enjoying a better quality of life because of Micra and the great care we provide at the Heart Rhythm Center at Stony Brook Heart Institute.

For more information about Stony Brook Medicine, call (631) 444-4000.

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