Illinois-based Northwestern Memorial Hospital to offer the world's smallest FDA-approved pacemaker for patients with bradycardia, a condition that abnormally slows the heart's rhythm.

Recently approved by the US Food and Drug Administration, the Micra Transcatheter Pacing System (TPS) is a new type of heart device that provides patients with the most advanced pacing technology at one-tenth the size of a traditional pacemaker.

Bradycardia is a condition characterized by a slow or irregular heart rhythm, usually fewer than 60 beats per minute. At this rate, the heart is unable to pump enough oxygen-rich blood to the body during normal activity or exercise, causing dizziness, fatigue, and shortness of breath or fainting spells. Pacemakers are the most common way to treat bradycardia to help restore the heart's normal rhythm and relieve symptoms by sending electrical impulses to the heart to increase the heart rate.

Micra is the only leadless pacemaker approved for use in the US. The first Illinois procedure was performed in May by Bradley Knight, MD, medical director of the Center for Heart Rhythm Disorders at Northwestern Medicine's Bluhm Cardiovascular Institute at Northwestern Memorial Hospital.

"This is another Northwestern Medicine first for our patients, who now have access to the next generation of pacemakers, a vital device for patients with heart rhythm disorders," said Dr. Knight, who is also the Chester C. and Deborah M. Cooley Distinguished Professor of Cardiology at Northwestern University Feinberg School of Medicine. "We are among the first hospitals in the United States to offer this device, which can greatly improve a patient's quality of life."

Comparable in size to a large vitamin, physicians at Northwestern Memorial have elected to use the Medtronic Micra TPS because unlike traditional pacemakers, the device does not require cardiac wires (leads) or a surgical "pocket" under the skin to deliver a pacing therapy. Instead, the device is small enough to be delivered through a catheter and implanted directly into the heart with small tines, or prongs, providing a safe alternative to conventional pacemakers without the complications associated with leads – all while being cosmetically invisible. The Micra TPS is also designed to automatically adjust pacing therapy based on a patient's activity levels. The device is implanted during an outpatient procedure.

The Micra TPS also incorporates a retrieval feature to enable retrieval of the device when possible; however, the device is designed to be left in the body. For patients who need more than one heart device, the miniaturized Micra TPS was designed with a unique feature that enables it to be permanently turned off so it can remain in the body and a new device can be implanted without risk of electrical interaction.

"The early use of the Micra TPS fits with our mission at the Bluhm Cardiovascular Institute — to advance the field of cardiovascular care with the most innovative techniques and procedures," said Patrick McCarthy, MD, executive director of the Bluhm Cardiovascular Institute and the Heller-Sacks professor of cardiothoracic surgery at Feinberg. "We're excited to offer this for our patients."

Northwestern Medicine's Bluhm Cardiovascular Institute is one of the top 10 national programmes for cardiology and heart surgery, according to US News and World Report, and consistently ranked the top cardiovascular program in Chicago, Illinois and the surrounding states.