New device means more patients now candidates for a leadless pacing option

BREVARD COUNTY – Parrish Medical Center is one of the first hospitals in the state of Florida to offer Micra™ AV, the world’s smallest pacemaker with atrioventricular (AV) synchrony. This new device, indicated for the treatment of patients with AV block, extends the most advanced pacing technology – at one-tenth the size of a traditional pacemaker – to more patients than ever before. The first procedure was performed by Interventional Cardiologist Rene Celis, MD, on Dec. 19, 2019 and since then 14 have been performed at Parrish Medical Center.

AV block is a type of heart block in which the electrical signals between the chambers of the heart (the atria and the ventricles) are impaired. Pacemakers, the most common way to treat AV block, help restore the heart's normal rhythm and relieve symptoms by coordinating the electrical activity of the atria and the ventricles. When this process – known as AV synchrony – is achieved, patients are healthier and have decreased likelihood of pacemaker syndrome, improved quality of life and increased blood flow from the left ventricle.

Historically, patients with AV block have been treated with traditional dual-chamber pacemakers which are implanted in the upper chest, under the skin below the collar bone, and connected to the heart using thin wires called “leads.” Micra™ AV has several internal atrial sensing algorithms which detect cardiac movement, allowing the device to adjust pacing in the ventricle to coordinate with the atrium, providing “AV synchronous” pacing therapy to patients with AV block.

“At Parrish Medical Center we are extremely proud to be the first in Brevard County to offer the latest fully self-contained pacemaker," said Dr. Celis. "This minimally invasive technology is a game changer. With nearly the same capabilities as a traditional pacemaker, we are able to offer an alternative that is cosmetically invisible to the patient post-implementation and implanted within 15-30 minutes. The Micra™ AV pacemaker has reduced the rate of complications by approximately 60%, decreasing infection rates and proving to be most ideal for older patients where a short recovery time is essential,”

Comparable in size to a large vitamin pill, physicians at Parrish Medical Center have elected to use Medtronic’s Micra AV based on its ability to deliver therapy via a minimally invasive approach. During the implant procedure, the device is inserted through a catheter and implanted directly into the heart with small tines. Because Micra AV does not require leads or a surgical "pocket" under the skin, potential sources of complications related to leads and pockets are eliminated - as are any visible signs of the device.

The Micra AV, world’s smallest pacemaker, is the latest cardiovascular advancement being offered as part of Parrish Medical Center’s cardiovascular service line. Parrish Medical Center was also the first in Brevard to offer the minimally invasive Impella® heart pump, an advanced, percutaneous cardiac assist device that pumps for the heart, allowing the heart to rest during stent placement or balloon angioplasty. The Impella heart pump is for patients with advanced heart failure, cardiogenic shock or to assist with protected percutaneous coronary interventions.

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