Pacemaker Technology Keeps Improving

Leadless pacemaker, smaller, lighter, fewer complications

A surgeon monitors a patient's lung activity after receiving a pacemaker on multiple computer screens. San Diego Health Magazine

Leadless pacemaker, smaller, lighter, fewer complications

The leadless pacemaker has opened new doors for patients with conditions like atrial fibrillation (AFib), bradycardia-tachycardia syndrome and sinus node dysfunction. Patients have the option of a smaller pacemaker that’s virtually unnoticeable and has fewer complications, and the benefits may extend well beyond the physical.  


“The nice thing about these miniature pacemakers is that you truly have no idea that you have it — unless you do an X-ray, nobody would know,” says Nicholas Olson, MD, a cardiologist at Scripps Clinic Anderson Medical Pavilion in La Jolla.  


“As doctors, sometimes we tend to concentrate more on the physiology, and we tend to minimize the psychology. The constant reminder of seeing a scar and something under your skin is a real psychosocial issue,” he says. “By creating a technology that is invisible I think we can really address that aspect. That’s pretty powerful and a real advantage. The last thing patients want to be thinking about is the technology that’s helping them live a happy and symptom-free life.”  

Continuous innovation 

Leadless pacemakers currently do have more limited applications. They typically are used for pacing only single-heart chambers, but more recently a dual-chamber pacing system also has been approved. More complicated pacing technologies for patients with heart failure are still in development.  


“We’re just scratching the surface of what leadless pacemakers can do,” says Dr. Olson.  

50 years of evolution 

Pacemakers have gone through an evolution of development.  


“We’ve seen 50 years of evolution of transvenous devices, our standard pacemakers. They’ve changed from a 40-pound box that you yield on a cart to something that goes under your skin that’s a quarter the size of your cell phone,” he says.  


“We’re still in the beginning when it comes to leadless pacing. We’re in the first couple generations of the device and I can only imagine what the future will bring.”  


Dr. Olson and his colleagues at Scripps are also involved on the research side of pacemaker development, working with leading medical device manufacturers to create and refine future leadless technology and advance the field as a whole.  


“The research, development and clinical trials of these leadless pacemakers, from upstream engineering to bringing it into real world use, is what I’ve concentrated my research efforts on in the last 10 years,” he says.  


“There’s some amazing engineering coming down the pipeline. My hope is that in 20 years, we won’t have to put a regular pacemaker in anybody again.”  

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This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.