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TheTimeIsChow t1_ir1b8ye wrote

I've had a pacemaker since I was 7 years old.

The wires are the single most limiting factor for recovery, long-term complications, and subsequently... how you're instructed to live your life post-op.

Over the past 25 years i've had a pocket dislocation, a wire pull out from the pacemaker, and an infected incision. All because I was just a kid trying to live a normal life.

This is something I've hoped for since I was like 12. There has been news about the development of something like this since around that same time.

This is far bigger news than what the article is portraying.

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Aanar t1_ir1fng2 wrote

My guess is it's only recommended for older patients? I don't think they can be easily explanted and there isn't room to put a new one in every 12 years over 70+ years.

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GimmickNG t1_ir1m4mh wrote

From the OP,

> The wireless pacemaker is about 90% smaller than the average pacemaker and the surgery lasts around 30 minutes. The battery life is also comparable with a traditional pacemaker’s 10-12 years and could be longer in some cases. Patients also will not have an incision scar on the chest or a bump protruding from the skin.

So if it's 90% smaller then there should be enough room to put in a new one every 10-12 years, unless people start living older than 100 with this device.

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Aanar t1_ir1nb9k wrote

They go in different places. This device is actually within your left ventrical. In a traditional pacemaker, only the lead is in the ventrical (and another in the atrium possibly) with the device located in a pocket under the collar bone. Traditional pacemakers are explanted when you need a new one. If the leads are still in good shape, the same leads are used with the new pacemaker, so there's no new net increase of volume of product being placed. If the lead isn't useable, then yes, they typically just put in a new one rather than try to extract the old one since explanting them can be risky. After about 3 or 4 leads though, you run out of room.

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pavelbure- t1_ir22ce0 wrote

AFAIK, the issue is the leads and human heart tissue. Cardiac tissue is partially conductive (conceptually, there are embedded, invisible, conductive channels).

It's not like skin, where you can re-implant into scar tissue or re-implant very close to another implantation location. The signal won't carry through the scar tissue. The lead wearing out (and coming out) comes with commensurate tissue scarring in an area. After a few implantations, you don't have a location that will carry the signal, reliably, as if it was natural cardiac tissue.

You want to replace/repair as few times as possible, to extend the utility of a pace-maker.

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mortenmhp t1_ir240tv wrote

Definitely. At least for the Micra, which is the only cordless in general use here we mostly use it for the most frail patients where we worry if the surgery of a regular pacemaker will be an issue or that the skin will heal properly if they have barely any body fat. If not for the price it'd probably be more popular, but even then we wouldn't recommend it if there were a chance of the patient outliving the battery.

The article says he implanted it in a 64 year old woman, which imo is way too young unless they plan to be able to remove it(doesn't look like it)

I'm curious how this is supposed to be a dual chamber pm though? Being cordless would almost by definition mean only having direct contact with the right ventricle. I'm wondering if it is just like the Micra av that tries to sense the atrial contraction to synchronize. That's not really dual chamber though. The article doesn't specify and I'm not very familiar with Abbott's cordless models.

Edit: looking up the aveir, it looks like they actually use 2 individual devices, one for right atrium and one for right ventricle, which communicates wirelessly. Neat. Also they wrote that it's designed to be extractable, which is nice i guess, but it is never unproblematic to remove something screwed into the heart. There is a reason leads are not rarely left even if they could be extracted.

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TheTimeIsChow t1_ir245db wrote

My guess, well my hope at least, is that this isn't the case.

I'd imagine that the lead/tip scars over into the heart wall and acts like a normal pacemaker wires lead. Then the device itself can be replaced. Whether it be 'unscrewed' or detached from the lead/tip in some way.

You could 100% be right. But I'd imagine this would be very high risk should the device see a premature failure and need to come out.

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PostenGhost247 t1_ir1zl93 wrote

I sincerely hope that you are able to get one of these as soon as possible. I wish you the absolute best outcome for your health. Take care.

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universityofga OP t1_ir09oj9 wrote

A cardiologist at Piedmont Athens Regional Hospital and professor of medicine at the Augusta University/University of Georgia Medical Partnership, Dr. Kent Nilsson has become an expert in implanting single chamber, wireless pacemakers. He was called upon again to test the dual chamber version as part of the clinical trial for the Abbott Aveir DR Leadless (wireless) Pacemaker System.
The wireless pacemaker is about 90% smaller than the average pacemaker and the surgery lasts around 30 minutes. The battery life is also comparable with a traditional pacemaker’s 10-12 years and could be longer in some cases. Patients also will not have an incision scar on the chest or a bump protruding from the skin.

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Blekanly t1_ir0ocsd wrote

My first thought was "why does everything need Wi-Fi these days..." but when it clicked, a pretty cool innovation

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azimir t1_ir1b4du wrote

Fuck yes. Maybe when my current unit needs a battery swap I can get an upgrade.

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mortenmhp t1_ir1z4pv wrote

If you are less than 60-70 years old at that point, I'd definitely go for regular pacemaker. If you get one of these, even if they last 10 they don't really pull them out again so instead of having one on your chest replaced, now you get to have 2 inside your heart. Additionally if you already have a pacemaker it makes little sense to just leave it and put a cordless in at the same time. It makes even less sense to open to the pacemaker to remove it for one of these when you could just replace the old one.

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azimir t1_ir210qy wrote

Welp, I've already got one so I guess it's with me for... ever.

I hope future generations keep seeing the benefits of these advances. I most definitely have!

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Vocalscpunk t1_ir3t8s9 wrote

Honestly in a few years all these rules might change. The major issue replacing pacemaker now is the wires, if they are usable then hot swapping a new pacemaker in the same variety you have now might make the most sense. If they're not usable then changing over might be a better call.

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Sqwrell315 t1_ird45zn wrote

My wife just had a Micra AV installed. It fires 3% and she can feel it fire. Do you feel anything??

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azimir t1_irdi6l1 wrote

I don't know that particular unit. It took me a while to stop noticing that the pacemaker was running. It was a new heart rate for daily life (about 15 bpm higher resting) and it was a weird feeling.

I also had to have some of the settings tweaked a few times. The biggest impact was from the setting which raised the rate when I stood up and started moving. It was on the default which was for a 80 year old in the hospital so it had a very slow response. I'm in my 40's so it needed to react much faster when I would stand and start moving. Once that was tuned somewhat almost all of the poor out of breath feelings when I would stand and move vanished.

As to "feeling it fire" - not directly. It's just my heart beating. The difference is when and how much. I also had a long time worrying about it. I (and my wife) did some therapy to help me understand the changes to myself and to address fears. That helped a ton.

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TriggerWarningHappy t1_ir37jnb wrote

Reading https://www.cardiovascular.abbott/us/en/hcp/products/cardiac-rhythm-management/pacemakers/aveir-vr-leadless-pacemaker/how-it-works.html they talk a lot about retrieval and claim "The Aveir VR Leadless Pacemaker's predicate device has a chronic retrieval success rate above 80% with helix fixation through 7 years, regardless of implant duration." - that's a little too jargony for me to confidently unpack, but it at least sounds like they'll try to take it out.

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vivikaks t1_ir1dzo3 wrote

Not sure if this is the same device, but we have the Medtronic micra at my icu for patients that qualify. It’s amazing! The entry is through a large vessel instead of through the chest. Recoup time is 1 day vs 7-10, plus no ugly sternal scar.

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crimsonblade55 t1_ir1yi79 wrote

I just got that one and it appears to be even smaller then those devices which would be great for me in like 5-10 years from now due to the small mobility issues the current one causes.

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Anatomy_Is_Destiny t1_ir1jx4y wrote

We have been implanting these devices for years now, so this is actually not new info. The Medtronic Micra is already on it's second model, and Abbott Medical just released the Aveir, their version of this. It is not a one size fits all replacement for traditional pacemakers, and can only be used for certain rhythm indications.

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IlliterateLibrarian1 t1_ir2i2xa wrote

This is the first truly dual chamber model so definitely a big step forward. Micra only is placed in the right ventricle however aveir has 2 components, one for the right atrium one for the right ventricle. This allows for a much larger patient population to be eligible

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Anatomy_Is_Destiny t1_ircrsoi wrote

Yes, my practice has already implanted a few of them thus far. The atrial leadless is not yet FDA approved, but hopefully within the next year.

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Scytle t1_ir1ghaj wrote

the real issues with these devices is that they are proprietary devices with insecure wireless connections, so if the company goes out of business your heart shuts down, or if they don't have good firmware your heart gets hacked. Same is true for insulin pumps, and a whole host of other medical devices.

There are just some things that shouldn't be private IP, or proprietary software, or even comodified under capitalism. This is one of them.

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Aanar t1_ir1rheo wrote

In the context of the article, it seems like "wireless" is being used to refer to the wired leads and not RF communication.

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FLacidSN4ke t1_ir41idk wrote

Oh sweet, I got to hold a demo of this a couple years ago. I've been wondering when these would start rolling out.

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FuturologyBot t1_ir0ci8a wrote

The following submission statement was provided by /u/universityofga:

A cardiologist at Piedmont Athens Regional Hospital and professor of medicine at the Augusta University/University of Georgia Medical Partnership, Dr. Kent Nilsson has become an expert in implanting single chamber, wireless pacemakers. He was called upon again to test the dual chamber version as part of the clinical trial for the Abbott Aveir DR Leadless (wireless) Pacemaker System.
The wireless pacemaker is about 90% smaller than the average pacemaker and the surgery lasts around 30 minutes. The battery life is also comparable with a traditional pacemaker’s 10-12 years and could be longer in some cases. Patients also will not have an incision scar on the chest or a bump protruding from the skin.

Please reply to OP's comment here: https://old.reddit.com/r/Futurology/comments/xvdi9k/georgia_doctor_implants_one_of_the_first_wireless/ir09oj9/

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Background_Dream_920 t1_ir1j1cj wrote

It’s only safer due to infection risk, eliminating the need to create a pocket for the device. It’s still invasive and is a 24f delivery system. Micra single leads have new very successful. It’s a good step forward.

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