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Setting the Pace


State of the art technology keeps any health care system equipped to maintain the highest standards of patient care, and the Ralph H. Johnson Veterans Affairs Health Care System sets the pace with a novel method of treating irregular heart rhythms.

 Last summer, the U.S. Food and Drug Administration (FDA) approved a dual-chamber leadless pacemaker system, the world’s very first dual-chamber leadless pacing solution for treating abnormal heartbeats. 

This is seen as a major advance because it opens up leadless pacing for most patients who suffer from an abnormal heart rhythm. With the careful hands of cardiologist Dr. Ann Kroman and attending electrophysiology fellow Dr. George Waits, the Ralph H. Johnson VA HCS became the first hospital in South Carolina to implant the device, and one of the first VA hospitals in the country to do so as well. While single-chamber leadless pacing has been around for years, most bradycardia, or slow heartrate patients, require dual-chamber pacing, meaning both the right atrium and right ventricle are paced. One of the more standout features of this pacemaker is the extended battery longevity. Under the right circumstances of usage and energy demand, the battery life could see 15-20 years as opposed to the previous standard of 8-12 years. 

The minimally invasive system is made up of two pacemakers, each smaller than a AAA battery. One pacemaker, an Aveir VR single chamber device, is placed on the patient’s right ventricle. The other pacemaker, the newly approved Aveir AR single chamber device, is placed on the patient’s right atrium. This methodology eliminates the need to create an incision in the chest for the pacemaker or transvenous leads, which EP experts say will reduce the number of complications and infections associated with pacemaker implants. Also noteworthy, patients with conventional pacemakers have range of motion limits for one month to decrease the odds of a lead dislodgement. With the new leadless pacemaker there are no range of motion restrictions. 

Chris Murrell, a Ralph H. Johnson VA HCS catheterization laboratory nurse who was on staff during the procedure, praises this method’s less invasive qualities and minimal downtime, especially knowing what it means to patients that have others relying on them. "It was so great to be able to help one of our patients who is not only a Veteran, but a caregiver for his mother. Implanting this device allowed him to continue to care for her without driving restrictions or range of motion limits."

 Edward Washington was the first patient in South Carolina to receive the dual-chamber leadless pacemaker and expressed gratitude for the excellence in care and fast recovery during the process. “I was worried before. My entire life was put on hold with all the restrictions because of my heartrate being so low. Now, I should be able to live my life doing the things I love with my fiancé. Just having a normal life is what I want.” 

Continuing to incorporate game changing innovations like this one means conducting meaningful research to provide breakthroughs in treatment and prevention of disease. The Ralph H. Johnson VA HCS continues making strides in staying at the forefront of groundbreaking medical technology in an effort to maintain the highest standards of Veteran care by providing innovative methods for treating patients and supporting their total health care needs. 

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