Lankenau Heart Institute at Paoli Hospital First in Region to Implant World’s Smallest Pacemaker Which Can Now Treat AV Block

Lankenau Heart Institute at Paoli Hospital First in Region to Implant World's Smallest Pacemaker Which Can Now Treat AV Block
New device means more patients are now candidates for a leadless pacing option

PAOLI, PALankenau 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

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