A Nevada first: Cardiologist implants world’s smallest pacemaker at UMC

By Scott Kerbs

Thursday, May 18, 2017 | 10:28 a.m.

UMC broke new ground in Nevada earlier this year when Dr. Arjun Gururaj performed the state’s first procedure to implant the world’s smallest pacemaker.

Gururaj used the revolutionary pacemaker to improve the life of Pamela Ham, a 67-year-old Boulder City woman with atrial fibrillation, a common form of cardiac arrhythmia that is characterized by an irregular heart rhythm. Pacemakers are designed to normalize a patient’s heart rhythm through electrical pulses.

“I just couldn’t believe how tiny it was,” Ham said of the device, which is about the size of a large vitamin. “It’s exciting, and I hope this procedure opens doors to a lot of other people who would benefit from this technology.”

Gururaj describes Medtronic’s Micra system as far more than the continued evolution of the pacemaker.

“It’s truly a revolution,” he said. “This device is a complete, compact pacemaker in an encapsulated device. It helps patients avoid open surgery and eliminates a number of significant risks.”

Approved by the U.S. Food and Drug Administration in April 2016, the Micra system is completely wireless and eliminates the need for open surgery during the process to implant the device. The device is guided to the heart through the right femoral vein in the groin, requiring only a small incision. It is delivered through a catheter and connected directly to the heart by prongs in the device.

The first procedure was a success, and it only took about 20 minutes. While Ham was placed under general anesthesia, Gururaj said the implant procedure can be performed with only local anesthesia, further reducing risks for many patients.

“After I program the device to increase its effectiveness, I expect Pamela to live a very easy life,” Gururaj said. “I am grateful for the opportunity to help Pamela overcome the effects of atrial fibrillation and make the most of her well-deserved retirement.”

For Gururaj, performing Nevada’s first Micra pacemaker implant at UMC was a considerable honor. In an effort to prepare for the procedure, he visited a Medtronic training center to receive in-depth training on the technology. This included performing the implant procedure on cadavers to prepare for a live patient.

He plans to perform more Micra pacemaker procedures at UMC, and he looks forward to assisting community members with this innovative technology. In addition to helping patients, he expects the introduction of this advanced technology to play a role in changing people’s perceptions of the local health care industry.

“It’s always been a thought that Las Vegas is behind the curve when it comes to technology, but this is not the case anymore,” he said. “We’re able to bring some of the latest and greatest technology to local patients, and we offer the high level of care that people expect from academic medical centers in America’s largest cities.”

Scott Kerbs is the physician experience coordinator at University Medical Center.