Bullet-sized pacemaker fitted inside Dubliner’s heart

A pacemaker made in Galway which is fitted inside the heart itself is helping to keep the heart of a patient in Dublin beating harmoniously.

Peter Cassells (82), from Blackrock, Co Dublin, is the first patient in Ireland to receive one of the next generation pacemakers, the Medtronic Micra, manufactured by medical device company Medtronic.

He received his new device on April 29th and has long since been up and about.

“Hats off for all those involved,” Mr Cassells said. “I am glad someone was looking after me.”

This latest pacemaker design is smaller than an AAA battery but can keep a patient’s heart beating smoothly for an estimated 12 years before the need for replacement.

Pacemakers are used if a person’s heart does not beat in a smooth rhythm. The device speeds up or slows down the heartbeat to a natural pace.

It is different to a defibrillator, which gives a strong shock to the heart if its main pumping chambers stop working properly.

Typical pacemakers are inserted under the skin close to the heart and have leads that connect the box to the organ.

The box protrudes from under the skin, and it and the wires can cause infections.

Right ventricle

This issue does not apply to the new device, which is anchored in the right ventricle of the heart.

There it monitors and controls the heartbeat, said Dr Jonathan Lyne, the cardiologist at the Blackrock Clinic who installed Mr Cassells's one.

“This is the most basic of pacemakers, but it is the start of the next generation and a move away from boxes and leads,” he said.

It is so small that it can be threaded through blood vessels in the thigh up to the heart.

It is only designed to help patients with an abnormally slow heartbeat, but this represents about a third of patients who need a pacemaker, Dr Lyne said.

It costs about €2,500 or so to implant a box-and-wires-type pacemaker but the new device is dearer, costing about €8,000, he said.

Health insurance companies do not cover the full cost of the device, he added.

About 3,500 patients a year receive either a pacemaker or implanted defibrillator in Ireland, he said.

Medtronic is headquartered in Dublin and has its main manufacturing plant in Galway. The company employs more than 4,000 people here.

A similar product is made by St Jude Medical, but it is not available here.

The Blackrock Clinic is the first hospital in Ireland to install the device.