New Pacemaker Technologies - Dave Fornell

In early 2016, the U.S. Food and Drug Administration approved the Medtronic Micra device, the first leadless, catheter-implanted pacemaker approved in the United States. It is the world’s smallest pacemaker at 0.8 cc in size. Micra has four self-expanding nitinol hooks that extend as it is unsheathed from its delivery catheter. These act as an anchor, hooking into the trabeculation at the apex of the right ventricle. “The problem with regular pacemakers is the wire that goes to the heart, because as the heart is beating and the wire has all this motion, over the course of time you can hear breaks in the wires. The idea with a leadless pacemaker is that you take the whole wire out of the equation,” said Vivek Reddy, MD, MS, professor of medicine and cardiology at the Icahn School of Medicine at Mount Sinai and director of cardiac arrhythmia services for the Mount Sinai Health System. Dr. Reddy said as a single-chamber pacing system, both the Micra and the Nanostim perform very well according to clinical trial data. Medicare is now reimbursing use of these devices.

• Vivek Reddy, MD, MS, Professor, Medicine, Cardiology, Icahn School of Medicine at Mount Sinai, Director, Cardiac Arrhythmia Services, Mount Sinai Health System
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