World’s smallest pacemaker implanted successfully at Calgary hospital

A Calgary surgical team is now implanting and studying the world's smallest pacemaker.

The Foothills Medical Centre is one of three hospital in Canada — and one of 55 internationally — involved in evaluating these devices, which are about an inch long and approximately the width of a pencil.

Aside from the smaller size, the device known as a leadless pacemaker has several advantages over the standard pacemaker:

• It is inserted non-surgically, which is less invasive and has a faster healing time.
• It also has a lower risk of infection and doesn't restrict people in terms of movement post-implantation.

"It's a pretty quick simple procedure. The person gets some medication to help them relax. We put freezing in the leg and then make a small nick in the skin and thread a tube into the heart where we can deliver the pacemaker," said Dr. Derek Exner. "It takes about 45 minutes.”

Exner, a cardiologist and heart arrhythmia specialist, has worked with his team to implant eight of the small pacemakers in Calgary.

Victor Bohonos was the first patient in Alberta and only the second in Canada.

Bohonos was set to receive a standard pacemaker back in September. The day before he was set to go in to surgery, he got a call asking if he wanted to be a part of the trial. He said he jumped at the opportunity.

"It's just a thrill for me to be a part of this," he said. "I've had no reaction from it at all, everything is just as normal as if I didn't have a pacemaker."

No mobility limitations

When Bohonos was researching pacemakers, he was told that there were several physical restrictions that came with the standard pacemaker. The day he got his pacemaker implanted, doctors told him he didn't have to worry about mobility limitations.

"I said to someone, ‘When can I play golf?’" Bohonos said. "Someone in the room said, ‘Tomorrow, if you can get a tee-time.'"​

Exner said there are different advantages of the standard pacemaker over the smaller one.

"The standard pacemaker has been around for a very long time, so we know all the things that can be good and bad," he said.

Standard pacemakers are easier to replace, if need be. Doctors simply need to make an incision and attach a new device.

"With the new one, it's going to be somewhat harder to remove it," he said. "You could if you needed to but we would probably just add another pacemaker inside the heart because they are so small."

Exner says the Foothills hospital performs about 850 standard pacemaker procedures every year. The new pacemakers are estimated to have a battery life of around 10 years.

The approximate cost of the device is $10,000, which is three-times more than the standard model.