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Next-Gen Miniaturized, Leadless Pacemakers Offer Longer Battery Life and Easier Programming

By HospiMedica International staff writers
Posted on 02 May 2023
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Image: The Micra AV and Micra VR transcatheter pacing systems (Photo courtesy of Medtronic)
Image: The Micra AV and Micra VR transcatheter pacing systems (Photo courtesy of Medtronic)

Heart block, also known as atrioventricular (AV) block, is a condition where the electrical signals between the heart's chambers (the atria and the ventricles) are disrupted. Historically, patients with AV block have been treated with conventional dual-chamber pacemakers, which are implanted in the upper chest, beneath the skin below the collarbone, and connected to the heart with thin wires called "leads." Over their roughly 60-year history, pacemakers have seen significant advancements, including miniaturization, improvements in pacing technology, MRI compatibility, and remote monitoring. Now, the latest generation of industry-leading miniaturized, leadless pacemakers offers a 40% longer battery life than their predecessors, along with numerous other benefits.

Micra AV2 and Micra VR2, the world's smallest pacemakers, from Medtronic plc (Dublin, Ireland) provide approximately 40% more battery life and easier programming than previous Micra pacemakers while retaining the many advantages of leadless pacing, such as reduced complications compared to traditional pacemakers. Similar in size to a multivitamin, Micra pacemakers are less than one-tenth the size of conventional pacemakers. Micra pacemakers eliminate the need for leads or a surgical "pocket" under the skin, thereby removing potential sources of complications related to leads and pockets, and leaving no visible indication of the device.

The Micra AV2 and Micra VR2 boast approximately 40% more battery life compared to previous generations, with a median projected battery life of nearly 16 and 17 years, respectively. This means that over 80% of patients who receive the pacemaker are expected to only need one device for life. The new Micra AV2 also features advanced algorithms that automatically program AV synchrony, thereby coordinating the heart's upper and lower chambers. Additionally, for active patients, the Micra AV2 offers a higher available tracking capability for faster heart rates (increased from 115 to 135 beats per minute for upper limits).

"Our goal is to improve the patient experience by continuously reinventing our ground-breaking leadless pacemaker," said Robert C. Kowal, M.D., Ph.D., general manager, Cardiac Pacing Therapies within the Cardiac Rhythm Management business, which is part of the Cardiovascular Portfolio at Medtronic. "Since inventing the first battery-operated cardiac pacemakers 65 years ago, Medtronic has transformed pacing technologies to benefit patients, including the nearly 200,000 patients globally who have received a Micra device so far."

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