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Smaller is huge when it comes to next-generation pacing devices.
In the world of medical devices, bigger certainly isn’t always better. And in the race for small, smaller and smallest in a minimally invasive-driven medtech market, tiny is ideal. Medical device giant Medtronic Inc. recently reported the first-in-human implant of what the company claims is the world’s smallest pacemaker—the Micra transcatheter pacing system (TPS). The device was implanted in a patient in Linz, Austria, as part of a global pivotal clinical trial. The Micra TPS is an investigational device worldwide. The study is a single-arm, multi-center global clinical trial that will enroll up to 780 patients at approximately 50 centers. Initial results from the first 60 patients, followed up to three months, are expected in the second half of 2014. At one-tenth the size of a conventional pacemaker, and comparable in size to a large vitamin, the Micra TPS is delivered directly into the heart through a catheter inserted in the femoral vein in the leg. Once positioned, the pacemaker is securely attached to the heart wall and can be repositioned if needed. The miniature device does not require the use of wires, known as “leads,” to connect to the heart. Attached to the heart via small tines, the pacemaker delivers electrical impulses that pace the heart through an electrode at the end of the device. Problems with leads have led to recalls in recent years. “Because of its small size and unique design, the Micra TPS can be introduced directly into the heart via a minimally invasive procedure, without the need for leads,” said Clemens Steinwender, M.D., head of cardiology at the Linz General Hospital in Linz, Austria. “The combination of this novel technology with a transcatheter procedure can benefit patients by potentially reducing pocket or lead complications and recovery times observed with traditional surgical pacemaker implants.” In contrast to current pacemaker implant procedures, the Micra TPS implant does not require a surgical incision in the chest and the creation of a pocket under the skin, which helps to eliminate a potential source of device-related complications, and any visible sign of the device. “Micra TPS is an example of the significant investment we have made in disruptive technology, specifically the miniaturization of implantable cardiac devices,” said Pat Mackin, president of the Cardiac Rhythm Disease Management business and senior vice president at Medtronic. “Less invasive, miniature device technologies show strong promise in improving patient outcomes and implant procedure efficiency. Through our global Micra TPS clinical trial, we intend to generate robust evidence of these benefits to patients and clinicians throughout the world.” In collaboration with leading clinicians, researchers and scientists worldwide, Medtronic offers the broadest range of innovative medical technology for the interventional and surgical treatment of cardiovascular disease and cardiac arrhythmias. Medtronic is headquartered in Minneapolis, Minn.
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