Doctors at the Silesian Heart Centre in Zabrze have implanted the world's smallest pacemaker in a 13-year-old boy. He is the world's youngest patient with a miniature pacemaker, which is ten times smaller than a standard pacemaker. On 12 February this year, a 13-year-old patient was implanted with the world's smallest pacemaker, Micra TPS (Transcatheter Pacing System), at the 1st Clinical Department of Cardiology, Congenital Heart Defects and Electrotherapy at the Silesian Heart Centre in Zabrze. This innovative medical technology was used for the first time in such a young patient. The boy was implanted with a pacemaker that is ten times smaller than a standard pacemaker. The implantation was performed transcatheter, without the need for an incision or the creation of a special subcutaneous "pocket". The young patient had undergone surgery several years ago to close a defect in the ventricular septum. Since then, the boy had experienced regular cardiac arrhythmias, which had been asymptomatic until now. In recent weeks, the patient had been experiencing discomfort associated with periodic disturbances in the electrical impulse conduction in the heart, leading to a significant slowing of the heart rate. This was decisive in the doctors' decision to implant a pacemaker in the patient. Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia. This method reduces symptoms, the frequency of fainting spells and, in high-risk patients, mortality, says Dr Oskar Kowalski, who performed the Micra implantation together with Dr Radosław Lenarczyk.The device monitors heart function, and the microscopic battery has a service life of over 10 years. Once it has been depleted, additional devices can be implanted without any problems, allowing the patient to use this form of therapy over a long period of time," explains Dr Kowalski.The fact that this pacemaker model does not require a silicone-coated electrode – the most unreliable and most frequently damaged or infection-causing element of the systems used to date – is particularly important for such a young patient, who can thus lead an active life,", says Dr Kowalski. The cosmetic aspect of this method of cardiac stimulation is also not insignificant for a teenager. "Implantation via a puncture in the femoral vein means that the patient does not have a scar on the chest, which is typical for the implantation of a conventional pacemaker,"explains Dr Kowalski. The use of the Micra pacemaker in children eliminates another important problem associated with the electrodes of a classic pacemaker – the problem of 'outgrowing' the electrodes. As a child grows after pacemaker implantation, the electrodes used become too short over time, requiring "extension", which in practice means attempting to insert the previously implanted electrodes deeper or replacing these elements. The use of an electrode-free pacemaker completely eliminates this problem. The first implantations of the Micra TPS miniature pacemaker in adults in Poland took place at the beginning of this year in two centres in Poland: in Zabrze and in Poznan.We are delighted that the recently introduced new technology for treating cardiac arrhythmias can already be used in patients who need it," says Dr Kowalski. Author: https://medicalonline.pl/ 22 February 2016
