Air Force Colonel gets leadless pacemaker

June 06, 2017 | by Edward-Elmhurst Health
Categories: Healthy Driven Hearts

The Rev. John O’Malley, 84, is not looking to retire anytime soon, despite completing long stints as an educator and chaplain (colonel) in the U.S. Air Force. Now he travels almost weekly to Catholic parishes around the country making appeals on behalf of those in need. He also regularly helps out local parishes by presiding at weekday Masses.

Earlier this year, O’Malley was taking medications for some heart problems, and he wasn’t about to let his ailments limit his activities. But one weekday in February, he fainted in church just as Mass ended.

A doctor who was at the service administered CPR and O’Malley was transported to the emergency department closest to the River Forest church. The doctors there said the likely cause of his fainting was chronic arrhythmia and associated brachycardia.

Brachycardia is a condition characterized by a slow or irregular heart rhythm, usually fewer than 60 beats per minute, or a rhythm with pauses. At this rate, the heart is unable to pump enough oxygen-rich blood to the body during normal activity or exercise, causing fatigue, dizziness, shortness of breath or fainting spells.

Given his new symptoms, O’Malley’s cardiologist Cash Casey, MD, of Elmhurst Hospital and Advocate Medical Group, said it was time to go beyond medications. He recommended a pacemaker, a device that sends electrical impulses to the heart to increase the heart rate and prevent pauses.

Dr. Casey told him he was a good candidate to become the first patient at Elmhurst Hospital to receive a newly FDA-approved type of pacemaker, called the MicraTM transcatheter pacing system (TPS). It’s appropriate only for patients like O’Malley who need pacing help in just the main pumping chamber (ventricle) of the heart.

HD Hearts micra

“About 80 percent of patients who need a pacemaker will need one for both chambers,” says Dr. Casey.

For patients who qualify, this leadless device offers several advantages. One is that it allows the patient to return more quickly to normal activities than a traditional pacemaker implant.

Says Dr. Casey, “It was important to this patient that he return to his active schedule as soon as possible. He was able to ride on an airplane several days after the procedure.”

The leadless MicraTM TPS is also less prone to complications.

“Pacemakers are made to withstand a lot, so problems are rare,” says Dr. Casey. “When a complication, such as an infection, does occur, it’s most often related to the leads (wires) or the surgical pocket. Neither of these elements is present in the MicraTM implant.”

With standard pacemakers, the doctor inserts a lead into an incision in the upper chest and guides it through the vein into the heart. Then the pacemaker is implanted in a pocket under the skin near the collarbone, where it’s connected to the lead.

The tiny MicraTM pacemaker is delivered via a catheter from the groin to the chest, where it’s implanted directly into the heart. The device remains in the heart chamber, taking up less than 5 percent of the space. Electrical impulses pace the heart through an electrode at the end of the device. There is no need for leads to deliver the pacing therapy.

Says Dr. Casey, “In essence, the battery, computer and lead components of a standard pacemaker are all combined in a miniaturized capsule.”

Dr. Casey performed O’Malley’s implant at Elmhurst Hospital in May 2017 with assistance from cardiac electrophysiologist Moeen Saleem, MD, of Edward Hospital and Advocate Medical Group, who’s previously performed the Micra procedures at Edward.

“I only had to avoid lifting anything heavier than a gallon of milk for one week,” says O’Malley. “I had great confidence in my doctors when they offered me this option. My goal was to avoid passing out in the future. I feel really good now. (After the ER visit) I delayed following up with my primary care doctor and the cardiologist. If something like this happens to you and you’re advised to follow up, I suggest you do it. I could have had this (implant) done two months earlier.”

Learn more about cardiac care at Edward-Elmhurst Health.


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