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Cutting-edge leadless pacemaker implanted at Royal Brompton Hospital

2 February 2016

A patient at Royal Brompton Hospital has become one of the first in the UK to be fitted with an innovative new pacemaker that works without leads.

Bill Hill, 78 from Buckinghamshire, was implanted with a Nanostim™ pacemaker in December to treat atrial fibrillation (AF), a heart condition that causes an irregular heart rate. 

Pacemakers work by monitoring the heart and providing electrical stimulation to set a pace to prevent the heart beating too slowly.

The Nanostim is less than 10 per cent of the size of a conventional pacemaker and is implanted directly into the heart via a catheter, which is a flexible tube inserted through a vein in the thigh. This differs from a standard pacemaker, which is placed in a ‘pocket’ created in the chest or abdomen during surgery with leads that are positioned in the chambers of the heart.

The pocket made to house pacemakers can be susceptible to infection, so leadless pacemakers are believed to reduce this risk. Unlike conventional pacemakers, they also eliminate the chance that the wires can malfunction.

The Nanostim, which is made by St. Jude Medical, is delivered through a catheter, which means patients are not left with a scar. It contains a built-in battery that lasts between nine and 13 years and the device can be retrieved if the battery needs to be replaced.

Bill was diagnosed with AF around six years ago after experiencing a strange episode when he suddenly went pale and felt unwell. He had not had typical symptoms of the condition, such as dizziness, palpitations, breathlessness and tiredness, but a 24-hour monitor showed he had an irregular heart rhythm and that, at times, he experienced long pauses when his heart did not beat. The way the heart beats in AF reduces its efficacy and can lead to low blood pressure, as well as blood clots that may cause a stroke. Bill was prescribed the drug warfarin, which thins the blood to prevent clots forming.

In June 2014 he collapsed while out walking and his doctors thought this was caused by his AF. After a cardioversion treatment, which delivers electrical energy to the heart to restore a normal rhythm, did not solve the problem, it was suggested that he have a pacemaker to prevent his heart beating too slowly.

Bill was referred to Dr Tom Wong, consultant cardiologist and electrophysiologist at Royal Brompton Hospital. He explained that the new Nanostim pacemaker was available to suitable patients as part of a clinical trial.

Bill, a grandfather of two, said: “Dr Wong told me that the new pacemaker was thought to reduce the risk of infection, which gave me confidence in having it implanted, and I liked the thought of having a brand new treatment.”

He had the Nanostim fitted in December and was discharged the following day.

“Now I’m boasting about my cutting-edge pacemaker to my friends who have the traditional ones. It feels good to be part of a trial, knowing I may potentially help other people. I’d recommend having it – especially if Dr Wong and his team are implanting it.”

Dr Wong said: “We are excited about the potential advantages that leadless pacemakers could bring to patients. This revolutionary technology offers an alternative to conventional pacemakers for patients who would benefit from a less-invasive procedure.

“These devices have the potential to help many people with heart rhythm problems and we are hoping to implant them in more patients who would benefit from this approach in future.”

Royal Brompton

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