Lankenau Heart Institute at Paoli Hospital first in the region to implant world's smallest pacemaker which can now treat AV block

Illustration showing the Micra AV inside of a heart

New device means more patients are now candidates for a leadless pacing option

Lankenau Heart Institute at Paoli Hospital, part of Main Line Health, is the first hospital in the Philadelphia region to offer Micra™AV, the world’s smallest pacemaker that maintains atrioventricular (AV) synchrony. The procedure was performed by Matthew Goldstein, MD, an electrophysiologist at Paoli Hospital. This new device, indicated for the treatment of patients with AV block, extends the most advanced pacing technology—at one-tenth the size of a traditional pacemaker—to more patients than ever before.

AV block is a condition where the electrical signals between the chambers of the heart (the atria and the ventricles) are impaired. Pacemakers, the most common way to treat AV block, help restore the heart’s normal rhythm and relieve associated symptoms by coordinating the electrical activity of the atria and the ventricles. When this process—known as AV synchrony—is achieved, patients are healthier and have improved quality of life, as well as increased blood flow from the left ventricle. Historically, patients with AV block have been treated with traditional dual-chamber pacemakers implanted in the upper chest, under the skin, below the collar bone, and connected to the heart using thin wires called “leads.”

“Our cardiac team is thrilled to be leading the way in improving care for our patients, ” said Dr. Goldstein. “With this technology, our patients can benefit from a life of leadless pacing, including a minimally invasive implant procedure and no visible device.”

Comparable in size to a large vitamin, Medtronic’s™ Micra AV can deliver pacemaker therapy via a minimally invasive approach. During the implant procedure, the device is inserted through a catheter and implanted directly into the heart. Because Micra AV does not require leads or a surgical “pocket” under the skin, potential sources of complications related to leads and pockets are eliminated—as are any visible signs of the device.

“This incredible pacemaker technology helps our clinicians to provide advanced cardiac treatment that improves the quality of life for our patients,” says William Gray, MD, system chief of the division of cardiovascular disease at Main Line Health and president of Lankenau Heart Institute.

Identical in size and shape to the original Micra Transcatheter Pacing System (TPS) approved in 2016, Micra AV has several additional internal atrial sensing algorithms which detect cardiac movement, allowing the device to adjust pacing in the ventricle to coordinate with the atrium, providing “AV synchronous” pacing therapy to patients with AV block.

Lankenau Medical Center participated in the pivotal global clinical trial and was one of the first hospitals in Pennsylvania to offer the Micra® Transcatheter Pacing System (TPS for patients with bradycardia),” says John Mitchell, system director, Main Line Health Cardiovascular Services and Lankenau Heart Institute. “It’s exciting that we can continue to expand the use of the MICRA pacemaker to deliver the latest technological advances in arrhythmia management to our cardiac patients across Main Line Health.”

Micra AV was approved by the U.S. Food and Drug Administration in January 2020.For information about the Lankenau Heart Institute’s advanced cardiac care, visit mainlinehealth.org/heart.

About Main Line Health

Founded in 1985, Main Line Health is a not-for-profit health system serving Philadelphia and its suburbs. Main Line Health's commitment — to deliver safe, high-quality, equitable and affordable care for treating and curing disease, playing an important role in prevention and disease management, as well as training physicians and other health care providers — reflects our intent to be the region's premier choice for clinical care, research, and education. A team of more than 13,000 employees and over 3,500 employed and independent physicians and advanced practice providers care for patients throughout Main Line Health.

At Main Line Health's core are four of the region's most respected acute care hospitals — Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital — as well as one of the nation's premier facilities for rehabilitative medicine, Bryn Mawr Rehab Hospital.

Main Line Health also includes Mirmont Treatment Center for drug and alcohol recovery; Main Line Health HomeCare & Hospice, which includes skilled home health care, hospice and home infusion services; Main Line Health Centers, primary and specialty care, lab and radiology, and other outpatient services located in Broomall, Collegeville, Concordville, Exton, King of Prussia and Newtown Square; Lankenau Institute for Medical Research, a biomedical research organization; and Main Line HealthCare, one of the region's largest multispecialty physician networks.

Main Line Health is the recipient of numerous awards for quality care and service, including the prestigious American Hospital Association Quest for Quality Prize, highest tier ratings from the Centers for Medicare & Medicaid Services (CMS) for Overall Hospital Quality and systemwide recognition in the 2023-2024 U.S. News & World Report Best Hospitals rankings. Main Line Health is committed to creating an environment of diversity, respect, equity and inclusion, has proudly received awards in this area and has embraced the American Hospital Association's #123forEquity Pledge to Act to eliminate disparities in care. We are dedicated to advancing patient-centered care, education and research to help patients stay healthy and live their best lives.

For more information, visit mainlinehealth.org and connect with us on social media:

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About Lankenau Heart Institute

The Lankenau Heart Institute is Main Line Health's premier comprehensive cardiovascular medicine and surgery program. Lankenau Heart Institute brings together the clinical expertise of all four Main Line Health acute care hospitals and both the employed and community cardiology practices to ensure that patients receive a level of quality, service and experience that is unparalleled in the region. Through the systemwide coordination of services, Lankenau Heart Institute delivers preventive, diagnostic, therapeutic and rehabilitative cardiovascular services at each of our locations including Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital.

Lankenau Heart Institute continues to be an innovator in the use of beating-heart techniques and robotic-assisted procedures for coronary artery revascularization, minimally invasive and transcatheter approaches for valve repair and replacement, complex aortic surgery and heart rhythm disorders. With our growing experience and focus on minimally invasive techniques, Lankenau Heart Institute has expanded participation in clinical trials year after year. Our physicians are frequently invited to participate in clinical/medical device trials, many of which are designed to facilitate the use of minimally invasive approaches and procedures.

With a collaborative team of expert consultative cardiologists, interventional cardiologists, electrophysiologists, cardiovascular surgeons and specially trained advance practice nurses and technologists, Lankenau Heart Institute is dedicated to managing and treating patients with simple to complex cardiovascular disease, including heart failure, aortic disease, coronary and peripheral vascular disease, lipid and genetic abnormalities, heart rhythm disorders and valve disease. Our team of cardiologists and cardiac and vascular specialists provide patients and their families with expert cardiovascular care, close to home.