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Unique achievement at Na Homolce: Doctors have introduced the smallest pacemaker in the world

Karolína Lišková
11.Jun 2020
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2 minutes

Nikola Kocová was born with a congenital heart defect. She was only 1 year old when she underwent her first surgery. Since then, she has been fighting for her life every day. The only thing keeping her alive is her pacemaker. But it was losing power way too fast. Thanks to a unique new device, which is so far the smallest in the world, ańd thanks to the supreme skill of Professor Petr Neužil from the hospital Na Homolce in Prague, the 23-year-old native of Prague can now finally live her life to the fullest.

Profesor Neužil patří ke špičce svého oboru.
Kardiostimulátor je opravdu maličký.
Pacientka nebude o stimulátoru vůbec vědět.

Nikola thus became not only the first Czech, but also the first European person to receive this new type of pacemaker.

"I'm really happy. I mean I'm anxious before the surgery, I keep worrying if everything will work out as it should, but if it does, I'll finally be able to live a normal life and I won't have to undergo another exchange for, another five years or so, I hope,"

the patient described her feelings for a few minutes before the procedure.

Prodej funkcionalistické vily Praha - 360m
Prodej funkcionalistické vily Praha - 360m, Praha 8

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Jeho tým voperoval nový typ kardiostimulátoru první pacientce v Evropě.
Jeho tým voperoval nový typ kardiostimulátoru první pacientce v Evropě.Source: archiv Nemocnice Na Homolce

A miraculous tiny capsule

The whole system consists of nothing but a very small capsule that is implanted directly into the right ventricle. This capsule combines a pacemaker and batteries and at the same time contains the electrodes needed for stimulation on its surface. The capsule has the shape of a cylinder, measuring 2.6 cm x 6.7 mm with a weight of no more 1.75 g.

These measurements make it 93% smaller than conventional stimulators. It is the smallest pacemaker in the world, about 10 times smaller than traditional pacemakers, and its lifespan is around 10 years. The implantation takes about 15 minutes, during which the patient remains conscious, as the procedure is practically painless. Local anesthesia is applied to the area where the guiding catheter is to be inserted. If there are no complications, the patient is discharged the day after the implantation.

"The new Micra AV offers a groundbreaking opportunity to detect mechanical movements of the atria and adapt ventricular pacing accordingly, so that it is coordinated with atrial contractions. Unlike the older types, it thereby enables the heart to maintain a completely natural interaction between the atria and the ventricles,"

Neužil explained the uniqueness of the new type of pacemaker, the development of which took three years. Once finished, the new function was verified and certified. The first implementation was carried out in February this year in the USA.

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Vývoj nového kardiostimulátoru trval tři roky.
Vývoj nového kardiostimulátoru trval tři roky.Source: archiv Nemocnice Na Homolce

There is hope for others

It has never been possible to achieve optimal transmission of electrical impulses between the atria and ventricles with a traditional pacemaker. Therefore premature depletion of the capacity of the battery system occured in all of them, prompting the need for more implantations. This particular patient underwent four of those, the last one in 2017. Repeated implantations also had very unpleasant cosmetic consequences for her.

According to Neužil, the existing pacemakerss stimulated the right ventricle regardless of the activity of the atria, which reduced their effectiveness by up to a quarter. Due to this, the existing stimulators were suitable only for five to ten percent of patients, mostly those with atrial fibrillation, where there is no mechanical activity in the atria of the heart. According to the doctor, the new stimulator may be suitable for up to half of all patients.

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Nemocnice Na Homolce
Nemocnice Na Homolce Roentgenova 37/2, 150 30 Praha 5
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