The pacing revolution continues with world’s smallest cardiocapsule

Diagram 1 – Micra™ AV transcatheter pacing system

It is the world’s smallest cardiocapsule – and with this miniaturized, sophisticated and complete pacing system, new opportunities to redefine the patients experience and reduce complications associated with traditional pacing technology, exists.  With the device no chest scar or visible bump is noticeable and it allows for fewer post-implant activity restrictions. The evidence supports that systemic infections or dislodgements related to the device are highly unlikely, with a very low revision rate, if at all necessary.

Traditional pacing systems are strongly associated with long-term lead and pocket-related complications, which achieve a staggering 10%. The Micra™ VR system effectively eliminates pocket-related complications such as haematoma, infection and erosion.

Lead-related complications such as fractures, insulation breaches and tricuspid regurgitation are also essentially completely eliminated.

The estimated longevity of the device approaches 12 years, exceeding that of traditional systems.

Currently the device is only funded for patients where traditional pacing access is impossible. The device is also available only for patients requiring single chamber rate-responsive pacing.

With the advent of Micra™ AV (the world’s smallest pacemaker with AV synchrony), the device accelerometer detects mechanical atrial activity and uses this information to deliver AV synchronous ventricular pacing.

It is expected that potential Micra™ AV candidates would include patients with AV block only, sinus node disease only, or sinus node disease and AV block, where as for example the Micra™ AV system, may be more suitable for those in atrial fibrillation (with AV block), or in anticipation of AV node ablation (ablate and pace strategy).  Currently Micra™ AV is not available in South Africa.