Researchers Develop the World’s Smallest Pacemaker, and It Could Be Revolutionary for Newborn Babies With Heart Defects
The new device is smaller than a grain of rice and gets absorbed by the patient’s body when it’s no longer needed, eliminating the risks of an extraction surgery
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Researchers have developed the smallest temporary pacemaker ever created. It’s littler than a grain of rice and is naturally absorbed by the body after serving its function. As detailed in a study published Wednesday in the journal Nature, the technology eliminates the risk of complications associated with surgically removing standard pacemakers, and it could be a game-changer for newborns with congenital heart defects.
The innovation marks a “significant leap forward,” Bozhi Tian, a researcher whose lab at the University of Chicago develops light-powered bioelectronics, tells the Agence France-Presse’s Daniel Lawler. Tian, who was not involved in the recent study, adds that “this new pacemaker is a transformative breakthrough in medical technology.”
Pacemakers are small implants that help the heart maintain a normal beat via electrical pulses. Temporary pacemakers are often required after heart surgery or while waiting for a permanent pacemaker. Today, patients who need one undergo an invasive operation during which surgeons attach electrodes, devices that conduct electricity, to the heart muscle. The electrodes are attached to an external pacing box, which delivers the electricity through wires that come out of the patient’s chest. When the patient no longer needs the pacemaker, a healthcare professional pulls the wires out.
The old technology, though, can cause infections, “because you have something inside the body that is now exposed to the outside environment through this wire,” Christopher Mehta, a cardiac surgeon at Northwestern Medicine, explained to Fred de Sam Lazaro and Sarah Clune Hartman at PBS in 2021, when the team first developed a dissolvable pacemaker. Mehta didn’t participate in either study.
Other risks associated with the procedure include infections, damaged tissue, dislodgment of the device, blood clots and bleeding. In fact, Neil Armstrong—the first person to walk on the moon—died from internal bleeding in 2012 after his temporary pacemaker was removed.
The novel pacemaker, however, is so small that it can be injected into the body with a syringe, meaning no wires are involved. And when the device is no longer needed, the body naturally absorbs it, so there’s no risky removal procedure, either.
“The patient will be more free to move around after the surgery,” Moussa Mansour, a cardiologist at Massachusetts General Hospital, told STAT’s Kevin Lin in 2021. That’s important, because “the more you keep the patient in bed, the more likely they are to develop clots in their legs or pneumonia,” as well as other complications, he adds.
The new, tiny pacemaker comes with a small, soft wireless device worn on the chest. When the external device registers irregular heartbeats, it automatically emits light pulses that activate and control the pacemaker. The miniature pacemaker is composed of two electrodes that, when in contact with the body’s fluids, form a type of battery called a galvanic cell, which converts chemical energy into electrical energy used to stimulate the heartbeat.
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Thanks to its size, the technology also has the potential to revolutionize the treatment of heart defects in newborns. In fact, “our major motivation was children,” Igor Efimov, a Northwestern University experimental cardiologist who co-led the study, says in a statement. He adds that 1 percent of children are born with heart defects, regardless of where they live. After surgery, the tiny patients only need a pacemaker for about a week, “but those seven days are absolutely critical. Now, we can place this tiny pacemaker on a child’s heart and stimulate it with a soft, gentle, wearable device. And no additional surgery is necessary to remove it.”
The researchers have tested the technology on lab animals and hearts from deceased organ donors. John Rogers, senior author of the study and a physical chemist at Northwestern University, suggests that human trials could take place in two or three years, according to the Agence France-Presse.
“It’s a paradigm shift in temporary pacing and bioelectronic medicine, opening up possibilities far beyond cardiology—including nerve regeneration, wound healing and integrated smart implants,” he adds.
