WIRELESS PACEMAKER IMPLANTATION

Traditional pacemakers used to treat bradycardia consist of one or more thin electrical wires, called electrocatheters, that are passed through veins into the heart under X-ray guidance and connected to a battery and processors measuring approximately 3 x 4 cm. The implantation of these traditional pacemakers involves a surgical skin incision at the chest and the use of local anesthesia to create a pocket under the skin in which to place the battery. Although the procedure is not overly invasive and complications are relatively rare, there is still a risk of short-term complications from the procedure, such as hematoma, pocket infection, pneumothorax, cardiac tamponade, electrode dislodgement, etc. and a long-term risk of malfunction and/or breakage of the electrocatheters and/or infection at the battery site that can reach the inside of the heart. Today, after much research, for some categories of patients, it is possible to use an innovative wireless pacemaker of very small dimensions, such that it can be introduced directly into the heart in a minimally invasive manner through a vein in the groin and without surgical incisions.

What is a wireless pacemaker?

The wireless pacemaker differs from conventional pacemakers in that it is so small that it can be positioned directly inside the heart, without the need to connect cardiac electrodes to a generator outside the heart. The new pacemaker has stimulation electrodes, battery and processors incorporated into a single device. It is a small cylinder about 2.5 cm long, weighing less than 2 grams and with a volume of less than 1 cc. The absence of the classic stimulation electrode wires reduces the possibility of the system experiencing malfunctions related to damage to the cables. The average battery life is about 8-9 years, varying from a minimum of 5 to a maximum of 15 years, and it is also magnetic resonance compatible and remotely controllable. With this technological innovation (very small size and absence of wires), we are no longer forced to use scalpels and stitches but the entire procedure is performed with instruments that are introduced through a simple injection in the groin, in a much less invasive way.

LEADLESS SYSTEM (WITHOUT WIRE)

What are the advantages of the wireless pacemaker for the patient?

This technology completely changes the patient's point of view. It involves a considerable reduction in implantation times, hospitalization times and risks associated with the procedure. Furthermore, since the patient does not have any scars, no subcutaneous pockets and does not feel any device under the skin and has an externally invisible device, he no longer experiences the fear of being a heart patient and the psychological impact is extraordinary. In fact, we go from a pacemaker wearer to a patient who has a device that he does not feel at all and who already has fewer limitations in terms of physical activity immediately after the implant because, being all inside the heart, it is more protected than a traditional pacemaker.

Implantation technique

The new wireless pacemaker contains the processor, battery and electrodes and is introduced using a completely innovative technique: no longer externally to the heart after an incision, subcutaneous pocket and connection to catheters, but rather introduced directly through the venous system using special introducer catheters and fixed directly into the heart at the level of the right interventricular septum. In practice, a minimally invasive procedure. Discharge is usually carried out within 24-48 hours of implantation. The procedure is performed under local anesthesia and lasts about 30 minutes. The non-surgical implantation method and the absence of catheters almost completely eliminate the risk of infections and device malfunctions.

For which patients is a wireless pacemaker indicated?

Unlike traditional systems, which can electrically stimulate the entire heart (atrium and ventricle), the new wireless pacemakers are able to act on only one cardiac chamber (the ventricle), therefore not all patients are currently eligible for the new application. The wireless pacemaker is designed exclusively for use in the right ventricle and is intended for those patients who require single-chamber ventricular stimulation according to current guidelines, i.e. patients with slow atrial fibrillation and patients with intermittent blocks and bradycardias.