Tiny Pacemaker Can Be Installed Via Catheter

the_newsbeagle writes "About four million people around the world have pacemakers implanted in their bodies, and those devices all got there the same way: surgeons sliced open their patients' shoulders and inserted the pulse-generating devices in the flesh near the heart, then attached tiny wires to the heart muscle. ... A device that just received approval in the EU seems to solve those problems. This tiny pacemaker is the first that doesn't require wires to bring the electrical signal to the heart muscle, because it's implanted inside the heart itself, and is hooked onto the inner wall of one of the heart's chambers. This is possible because the cylindrical device can be inserted and attached using a steerable catheter that's snaked up through the femoral artery."

Re:Catheter?

[Russ1642]

Yes, it's a urinary catheter. To get to the heart. The two are directly connected, similar to your case where the brain is directly connected to the asshole.

Technical correction and comment by a cardiologist

[cecst]

The leadless pacemaker is indeed a real advance, but the summary needs a few corrections, and a comment can be made. I would not want a reader who needs a standard pacemaker to be frightened unnecessarily by the summary as written.
"surgeons sliced open their patients' shoulders and inserted the pulse-generating devices in the flesh near the heart, then attached tiny wires to the heart muscle ... through the femoral artery."

• 1. The incision is made in the skin, not a joint. The implant location is usually the left or right prepectoral region, which is an inch or two lower than the collar bone on the stated side. The pacemaker itself is placed in a "pocket" formed by separating the skin and its attached fat from the underlying muscle. If you have ever eaten chicken, you know that the skin and fat can be separated from muscle. In the uncooked human, of course, separation requires a bit of effort but not much, and a good surgeon will have the area complete numbed up so the patient doesn't feel anything. Thus, the pacemaker is not near the heart: it's outside the rib cage. There are variations on the implant location, but none of them is inside the rib cage.
• 2. The tiny wires (well, pretty tiny) are long, and extend from the area where the pacemaker is through a vein (not an artery, hopefully!) to the heart. The method by which the wires are put in the vein is simple but outside the scope of this post.
• 3. The access is always through a vein (femoral vein, in the case of the new device), not an artery. Blood clots (thrombi, when inside the body) will form on most foreign bodies. From the veins, they can spread only into the lungs, which is relatively safe. From the arteries, even tiny thrombi can cause trouble when they go the brain (strokes), heart (heart attack), gut (ischemic gut), limbs (ischemic arm, leg, etc). Not good.
• 4. The new device can still get infected and still can run out of battery power. What I haven't yet understood is how it can easily be extracted if it gets infected, which is necessary because life-threatening infection can (and usually does) result if an infected foreign body remains in the patient. I guess it's small enough that a new one can be inserted without removing the old one when the battery runs out. There are more technical limitations too that will likely be overcome as the technology improves.