What is a leadless pacemaker?
A pacemaker is used to treat slow heart rhythms. Your pacemaker will provide a small electrical impulse to stimulate the heart to beat. The pacemaker monitors your heart rhythm; if it is too slow then the pacemaker will initiate a heartbeat. Unlike a normal pacemaker, the pacemaker will not have a lead but has small flexible hooks which allows the device to be secured within the heart. It is implanted into the heart through a vein in the leg. There will be no visible sign of the device under the skin.
The video below gives useful information on the procedure for your pacemaker.
Micra™ Patient Animation
If your heart beats too slowly, this condition is called bradycardia.
To restore your heart’s natural rhythm, your doctor may recommend the implantation of a pacemaker.
Traditionally, pacemakers are implanted in the upper chest, just below the collarbone, under the skin. The pacemaker device, which is battery-powered, is connected to the heart by wires called leads. These leads allow the pacemaker to send electrical impulses that help stimulate the heart.
Now, there is a new option: Micra.
Micra is the world’s smallest pacemaker, about the size of a vitamin capsule. Despite its small size, Micra functions just like a traditional pacemaker, sensing and pacing the heart.
Unlike traditional pacemakers, Micra is implanted directly into the right ventricle of the heart, making it completely invisible from the outside. This eliminates the need for leads, chest scars, or a visible pacemaker bump under the skin.
The Micra device is implanted through a minimally invasive procedure. A catheter, resembling a straw, is inserted into a vein, typically near the upper thigh, and is guided to the right ventricle of the heart. Once in place, the Micra is secured against the heart wall with flexible tines.
An external programmer is then used to test and program the device. After that, the catheter is removed, and the incision is closed.
Micra is designed for patients who need a single-chamber (also known as a ventricular pacemaker or VVI pacemaker).
If you’re considering this option, talk to your doctor to discuss the benefits and risks of the Micra pacemaker.
Aftercare at home
The leg area where the pacemaker is implanted can often be tender with minor bruising after the implant, but this should resolve. You should avoid hot baths/showers and strenuous exercise for at least two days after your implant, to allow your groin to heal.
If you are worried about the implant site, please contact your Pacemaker clinic or the ward L14 for advice.
Follow-Up
We will arrange for you to attend Leeds General Infirmary or St James University Hospital approximately 6-8 weeks after the pacemaker implant. This is to check the device measurements and ensure you have no issues with your leg.
Your Pacemaker ID card will be provided at this check. It is vital that you carry this card with you at all times, as it gives health professionals important information about your pacemaker.
We will offer you a home monitor for your pacemaker; this device allows us to check your pacemaker from home and reduces trips to hospital. Frequency of follow-up is dependent on a variety of factors, which the Cardiac Physiology team will advise you on. The Cardiac Physiology team will utilise the appointments (either face-to-face or remotely) to assess symptoms, the battery life of your pacemaker and optimise programmed settings.
These appointments are extremely important to attend, to ensure your pacemaker is working well.
Getting back to normal
Returning to everyday activities is an essential part of recovery. It is usual for patients to return to work approximately 1 week post-implant.
Most individuals can resume normal activities and exercise as soon as they feel able. It is advisable to increase the amount you do gradually.
Sexual activity
You can resume normal sexual activity as soon as you feel able.
Driving
The rules for driving are set by the DVLA (Swansea SA99 1TU).
These are for your safety and for the safety of other road users.
• You should notify the DVLA if you have received a Pacemaker.
• You will need to complete a form to notify the DVLA.
• Patients with Pacemakers, including a box change, are not allowed to drive a car (Group 1 licence) for one week post implant.
• Patients with Pacemakers, including a box changes are not allowed to drive a bus or lorry (Group 2 licence) for six weeks post implant.
As with many regulations, things change over time. The latest guidance can be found at the DVLA website. If you are unsure, please ask the team for advice. It is your responsibility to inform your insurance company that you have a pacemaker implanted.
Electrical interference and pacemakers
The risks from most appliances are theoretical risks and do not occur very often
Most everyday household and office equipment can be safely operated, as there are built in features on the pacemaker to protect it from most sources of interference.
Any electrical equipment must be in good working order and properly earthed.
Handheld appliances and power tools should be kept at least 30 cm away from the implant site to prevent any potential interference.
Hospitals and dentists
It is essential to inform your doctor, dentist or surgeon that you have a Pacemaker fitted as some procedures require precautions.
Magnetic Resonance Imaging (MRI) used to be considered unsafe but newer pacemakers have been designed to operate safely during MRI scans, though specific precautions need to be taken. www.mrimypacemaker.com
CT/CAT, diagnostic X-ray or ultrasound are all safe.
Most dental procedures are also safe (drilling, ultrasound cleaning etc.).
There are certain procedures that may require reprogramming of your pacemaker; this will usually be arranged by the referrer.
Please speak to your Pacemaker Clinic or Cardiologist if you are concerned.
Travelling with a Pacemaker fitted
It is safe to travel on aeroplanes after two weeks
Please ensure your travel insurance company know about your pacemaker and that your cover is appropriate.
Caution may be needed near security scanners in airports Portable wand devices can be safely used providing they are scanned briefly over the device area.
Additional Information
Pacemaker battery life varies depending on model and how much they are being used, on average around seven years. Regular checks by the pacemaker clinic ensure that the battery life is monitored and we will arrange for this to be changed, when the time comes.
Pacemakers go through testing before we are allowed to use them. Like all electronic equipment, unexpected faults may occur from time to time and these would be picked up by the pacemaker team.
If we receive warning of a problem with a particular model of pacemaker, we may need to see you more. If there were to be any problems that we felt put you at risk of harm, your Cardiologist would talk to you about replacing the device early.
What happens when the device needs a new battery?
We will arrange for you to attend and the procedure will be exactly the same as the first time around. Your old pacemaker will not be removed.
Useful contacts
St James Pacemaker Clinic
(Monday-Friday 9:00am-4:30pm)
Leeds General Infirmary Pacemaker Clinic
(Monday-Friday 9-4.30pm)
LGI Ward Cardiology Day Case (L14)
For emergencies out of hours please contact:
LGI Coronary Care (L20) Ward number
Other useful numbers/websites:
DVLA driver’s medical branch
Swansea