When you think of a "pacemaker," you probably picture a device that looks like a small lump under the skin of your chest, connected to a bunch of wires. But with the advancement of medical science, there is now a much simpler, smaller, and wire-free technology. Today, we're talking about that little miracle: a 'Leadless Pacemaker.'
What is this leadless pacemaker?
Simply put, it's a very small, single-unit device. Your doctor inserts it directly into your heart. What does it do? Stop your heart rate from slowing down.
Unlike a regular pacemaker, it doesn't have a separate battery or leads. Everything is inside this little cylinder. The entire device is placed in the right ventricle of your heart. Imagine, it's smaller than a AAA battery, about 1.5 inches long, to be exact.
How does this little device work?
This is a very intelligent device. The doctor programs it and implants it in your heart. The pacemaker then "listens" to your heart's natural electrical signals.
If your heart rate suddenly drops below the required level, this device senses it and delivers a very small electrical impulse to the heart. This causes the heart to start beating normally again. This means that it only works when needed.
Who is this suitable for?
Pacemakers are usually needed for people with slow heart rates. In medicine, we call this ``Bradyarrhythmias.'' That is, when the heart beats slowly due to a disease in the heart's electrical signaling system.
A leadless pacemaker may be especially suitable for people with the following conditions:
- For those who only need the help of a pacemaker for their heart sometimes.
- For those with a condition where the heart rate slows or stops (Atrial Fibrillation - Afib).
- For people with a condition called `AV block`.
- For those who have ``Bradycardia-tachycardia syndrome'', where the heart rate sometimes slows down and sometimes speeds up.
- For those who experience symptoms such as dizziness due to a slow heart rate (`(Bradycardia)` with symptoms).
But this is not suitable for everyone. Currently, this device is used for people who need pacemaker support for only one chamber of the heart.
Your doctor will decide whether this is right for you. He or she will ask you about your:
- Disease history
- Heartbeat pattern
- Scan reports such as ``(Echocardiogram)`` are examined.
How should I prepare before this surgery?
This is not a major surgery, but you need to take care of these things before it happens.
- Arrange for someone to take you home after surgery.
- The doctor will advise you on when to stop eating and drinking before surgery and what medications to stop taking.
- Never stop taking your medication without your doctor's advice.
How to perform the surgery step by step
This process happens like this. It usually takes about 30 minutes.
1. First, your groin area will be tingled.
2. Then a very small incision is made in that area.
3. Through that incision, a thin tube called a ``Catheter'' is inserted into one of your veins, the ``Femoral Vein''.
4. While looking at an X-ray machine, the doctor carefully guides the tube all the way to your heart.
5. This small pacemaker is implanted and fixed in the right ventricle of the heart.
6. Then, check to see if it is working properly and is installed properly.
7. If everything is OK, the tube will be removed and the incision will be closed.
After the surgery, you will have to stay in the hospital overnight. The next day, the pacemaker will be checked again and a chest X-ray will be taken before you are sent home.
What are the pros and cons?
Like any medical procedure, there are pros and cons. Your doctor will discuss these with you and help you choose what is best for you.
| Pros | Cons |
|---|---|
| Because there are no wires (leads), the risk of wire breakage or infection is much lower. | Only one cell in the heart can help. |
| Since no surgical pocket is created under the skin of the chest, there is no discomfort or scarring. | If the heart suddenly stops, it cannot be revived (defibrillated). |
| The time taken for surgery is less. | There may be swelling or bleeding at the incision site. |
| There are no restrictions on upper body activities after surgery. | There is a very rare risk of heart damage. |
| It is about 90% smaller than a typical pacemaker. | More expensive than traditional pacemakers. |
| MRI scans are safe for testing. | There is a rare risk of the device falling out of place. |
A few more important things to know
How long will this last?
The battery usually lasts between 5 and 15 years. When the battery runs low, the doctor can turn off the old pacemaker and insert a new one right next to it. It won't be a problem if the old one is still there.
How long does it take to heal?
You can usually resume your normal activities after about two weeks.
Can I go for an MRI scan?
Yes. Most of the time, these are safe for MRI scans. But it's important to talk to your doctor and confirm before going for it.
When should I see the doctor again? What symptoms should I report immediately?
You have to see the doctor on a specific schedule. To see if the pacemaker is working well, if the battery is good, and if you are recovering well.
- Within 24 hours of surgery
- In a month
- Then every 3, 6, or 12 months.
If you have these symptoms, call your doctor immediately.
- If there is an infection (redness, swelling, pus) or bleeding at the incision site.
- If your ankle or foot swells.
- If you experience symptoms (such as dizziness) that were present before the pacemaker was inserted again.
- If you suddenly feel faint or dizzy.
- If you have difficulty breathing.
It's normal to feel a little scared and nervous when you think about having a medical device inside your body. But you're not alone, millions of people around the world live normal lives with a pacemaker. A leadless pacemaker is not the best solution for everyone, and a traditional pacemaker may be better for some people. So talk to your doctor about any questions or concerns you may have. He or she will help you choose the best option for you.
Take-Home Message
- A leadless pacemaker is a wireless, very small device that is implanted directly into the heart.
- This is mainly used for people with slow heart rate (bradycardia).
- The surgery is very simple. It is inserted through a small incision in the groin.
- The risk of complications such as wire-related infections and breakage is much lower compared to regular pacemakers.
- Your doctor is the best person to decide whether this is right for you, so talk to him or her openly about it.
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