Cardiovascular disease is one of the leading causes of death and disabilities in the world and it affects individuals of all ages, races and genders. Arrhythmia, specifically Bradycardia, is one type of this multifaceted disease which causes individuals to suffer from an abnormally slow heart rate and is a result of damage caused by either disease, injury or genetics to the heart tissue or to the electrical signal that controls the heartbeat. One of the main forms of treatment for Bradycardia is the implantation of a leadless pacemaker in the right ventricle. Leadless pacemakers are small self-contained devices that use electrical pulses to prompt the heart to beat at a normal rate. Ammari (2018) reported that the leadless pacemaker has a total success rate of 94% and there was a 100% success rate in patients implanted for less than six weeks and a 91% success rate in patients who were implanted for more than six weeks. Its high-rate response and compatibility with Magnetic Resonance Imaging are two of the distinguishing features of the leadless pacemakers.
The normal heartrate of an individual can fluctuate over the course of 24 hours and individuals with Bradycardia are unable to properly speed up their heart rate depending on the physical activity performed, resulting in them experiencing fatigue. The high-rate response feature makes the pacemaker more adaptive to the patient and changes the heart rate depending on the level of physical activity. One technique by which the rate response is implemented is the integration of two types of sensors within the pacemaker. One sensor is an unspecified fast reacting sensor and the other is a highly specific slow metabolic sensor. The sensors automatically increase or decrease the heart rate according to the body’s needs which results in a 4-to-5-fold increase in cardiac output (Dell ‘Orto, Valli and Greco, 2004). The rate responsive pacing can closely mimic the normal heart rate thereby meeting the individual needs of the patient.
Magnetic Resonance Imaging is the recommended and preferred technique used by cardiologists to check for heart diseases. Magnets and radio waves are used to create images of the different organs in the body and provide clear images to the cardiologist to show the flow and blood throughout the heart. Research posits that up to 75% of patients with a pacemaker will need MRI’s over the course of their lifetime (Kalin, 2005). The leadless pacemakers are built with shielded components to prevent overheating and the pacemaker’s generator is also shielded to protect it from the powerful magnets. Another technique used to improve compatibility is SafeScan mode which continues to provide an appropriate pace to the patient’s heart during scans (Tobias, 2011). There are some reactions which can occur when an MRI is performed on patients with pacemakers therefore the compatibility of leadless pacemakers with this procedure improves the relationship between the two.
The development of the leadless pacemaker represents a new era of device therapy. Each of these characteristics allow a faster recovery time and fewer complications during the procedure, future tests and overall daily life.
By Matthew Dahoo