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micra

Dr. Jagroop Basraon, an electrophysiologist at Saint Agnes, holds the new Micra Transcatheter Pacemaker, which is about the size of a bullet. Photo by Donald A. Promnitz

published on September 26, 2017 - 1:38 PM
Written by Donald A. Promnitz

A smaller, safer and longer-lasting pacemaker has found its way into the Central Valley, where it’s making patients’ lives — and doctors’ jobs — easier.

Approved of in April by the U.S. Food and Drug Administration, the Micra Transcatheter Pacemaker has been introduced to Fresno by Saint Agnes Medical Center, the only group in the Central Valley to use it. So far, four patients have received the device.

“It’s been around in Europe for a few years,” said Dr. Jagroop Basraon, an electrophysiologist at Saint Agnes, “and it’s been in clinical trials in the U.S. for about a year.”

Pacemakers are devices that send electrical impulses to a patient’s heart to regulate their heartbeat. A product of the Irish medical device company Medtronic, the Micra is much smaller than the traditional pacemaker, leaving no indentation or ability to feel under the skin.

“For a lot of patients, that is a big decision. Some of the younger women patients, they don’t want it for aesthetic reasons,” Dr. Basraon said. “People want it covered up and so a lot of the time, patients refuse pacemakers for that.”

The Micra lasts 11 to 13 years when in constant use, which is three to five years longer than a traditional pacemaker. Its insertion into the patient is also able to be done using a much simpler and safer procedure.

“The most important thing is, it’s not a big surgery,” Dr. Basraon said. “We just go in from the groin, put in a tiny IV, which we then dilate, and then advance the device through the groin without the cutting and suturing of an incision.”

The Micra travels through a 5mm tube to the right ventricle, which pumps blood to the lungs. The procedure takes less than 30 minutes to complete and the recovery time is four hours, meaning that a patient can be in and out of the hospital in a single day.

One reason for the easy application of the Micra is that it does not require a lead — the wire that sends electric signals to the patient’s heart. Instead, it relies on small, prong-like protrusions known as “tines.” These grip the heart, sending the electric signal.

The Micra, however, is not for everyone. Dr. Basraon said in a patient with two chambers in need of stimulation, a pacemaker with two leads would be needed so the atrium could be stimulated. The tines Micra can also be dislodged, though this can be said of leads as well.

Nonetheless, those who have received this newer pacemaker are reporting that their lives have been vastly improved as a result. This was the case with Winifred McCoy, 84, the first patient in the Central Valley to have a Micra implanted.

“I’m much more active. I’m back to doing all the things I enjoyed doing — going to lunch with the girls, taking part in potlucks, having the grandkids over, and just enjoying life,” McCoy said. “But the main thing, I’m able to see my husband every other day and take care of him.”

McCoy’s husband Thomas suffers from Alzheimer’s disease and had to be placed in convalescent care after an illness. McCoy tries to spend time with her husband whenever possible, but has atrial fibrillation — an irregular heartbeat that made it difficult to care for Thomas.

“I was having difficulty breathing. He loved to walk around and I’d have to push the wheelchair,” McCoy said. “I got where I had to tell him: ‘I can’t do it anymore.’”

Because she was the first patient to receive the Micra at Saint Agnes, she was kept overnight, but now with the pacemaker inside of her, McCoy said that she has her life back and is able to devote more time to her husband. This includes their walks together.

“I push him all around,” McCoy said, “so he can visit with other patients.”


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