Image of a pacemaker with text that says, MemorialCare Heart and Vascular Institute at Long Beach Medical Center implants smallest pacemakers allowing cardiac treatment without incision.


Many adults who suffer from an irregular heart beat or arrhythmia may be required to have a pacemaker implanted. The relatively small device sends electrical impulses to the heart muscle to help the organ maintain a suitable heart rate – essentially, helping the heart to beat “normally.”

Pacemakers are connected to the heart by way of wires, called “leads.” The leads that send impulses from the pulse generator to the heart while also monitoring the heart’s electrical activity. Each impulse from the lead causes the heart to contract. Some patients require a pacemaker with one, two or even three leads. These also are called single, dual or three chamber pacemakers.

Serge Tobias, M.D., medical director, electrophysiologyMemorialCare Heart & Vascular Institute, Long Beach Medical Center, is pioneering the way in pacemaker technology by implanting the world’s smallest pacemaker. The new single-chamber pacemaker has no leads and is delivered percutaneously, meaning through a needle through the groin rather than an incision on the chest. The pacemaker is about the same size as a bullet and has little “barbs,” sharp protections, to attach to the heart and “grabs” on to the right ventricle.

These leadless pacemakers can reduce potential infections, eliminate the need to have an incision and reduce the risk of having another surgery if a lead fails. Patients who are candidates for a single chamber or single-lead pacemaker are ideal candidates for a leadless pacemaker.

“These pacemakers are revolutionary in cardiac treatments,” says Dr. Tobias. “With these devices, no incision is required and there are no leads like traditional pacemakers. There is a reduction in the risk of infection and the risk of a dislodged lead or future extraction.”

One of the biggest benefits of these pacemakers is they reduce the need for lead extraction – removal of implanted leads. If the pacemaker was recently implanted, removal of the lead wires is relatively simple. However, if scar tissue has begun forming, it could mean a more complicated extraction. Dr. Tobias and his cardiac surgery team then begin the process of surgically inserting a replacement lead or removing the malfunctioning lead.

“The reduction in the need for lead extraction is a great benefit for our patients,” says Dr. Tobias. “We have already implanted four of these devices, and look forward to the next one.”