Houston Methodist Sugar Land Hospital is the first in Fort Bend County to successfully implant a breakthrough pacemaker designed to treat atrioventricular (AV) block. AV block is a slow heart beat due to a lack of communication between the top and bottom part of the heart.


Board-certified electrophysiologist Apoor Patel, M.D., of Houston Methodist DeBakey Cardiology Associates at Sugar Land, performed the procedure in March, implanting the new Micra™ AV pacemaker in a 80-year-old female patient. The device was approved by the U.S. Food and Drug Administration in January 2020. 


“The new device is a significant advance in technology that helps restore the heart’s normal rhythm and eliminate the symptoms of AV block without the potential discomfort and complications of traditional pacemakers,” said Patel.


The new pacemaker is one-tenth the size of a traditional pacemaker – comparable in size to a large vitamin – and can be inserted via catheter directly into the heart in a minimally invasive procedure. Because it does not require a surgical pocket under the skin, there are no visible signs that the device is in place – a common patient complaint about traditional pacemakers.


AV block is a condition that impairs the electrical signals between the chambers of the heart, known as the atria and the ventricles, which can lead to fainting, dizziness, fatigue, passing out, shortness of breath and chest pain. The pacemaker helps restore the heart's normal rhythm by coordinating this electrical activity to ensure a proper heart rate and normal blood flow.


When this rhythm – known as AV synchrony – is achieved, patients are healthier and have an improved quality of life.


“The device utilizes internal atrial sensing algorithms that detect cardiac movement, allowing the device to adjust pacing in the ventricle to coordinate with the atrium,” said Patel. “This constant algorithmic sensing provides superior AV synchronous pacing therapy to patients with AV block.”


Traditional pacemakers are implanted in the upper chest, under the skin below the collar bone, and connect to the heart via thin wires known as leads. The location and connectivity of traditional pacemakers sometimes lead to long term complications.


Because it is lead-less and is placed directly in the heart, the device reduces the likelihood of some of the complications associated with traditional pacemakers.


“Having a device in one chamber of the heart that can in turn sense the other chamber of the heart and help the heart beat in a coordinated fashion is a novel breakthrough,” said Patel. “We are excited to be able to offer patients this new technology when indicated.”