Health Awareness
Paid for by Royal Brompton and Harefield
Professor Tom Wong
Consultant cardiologist and electrophysiologist, Royal Brompton and Harefield Hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust
New pacemaker technology is improving life for patients with heart rhythm disorders. Devices are now wireless, much smaller and minimally invasive.
Heart rhythm disorders, or arrhythmias, are more common than you might think. In the UK, over 2 million people are affected.1
Arrhythmia symptoms and detection
Arrhythmias occur when the heart’s electrical system is disrupted, causing the heart to beat too fast (tachycardia), too slow (bradycardia) or irregularly. Untreated bradycardia can cause fainting, falls, heart failure and can be life-threatening.
“Early detection prevents potentially devastating consequences,” says Professor Tom Wong, consultant cardiologist and electrophysiologist at ‘Royal Brompton and Harefield Hospitals, part of Guy’s and St Thomas’ Specialist Care, which provides private care through Guy’s and St Thomas’ NHS Foundation Trust.’ “Unfortunately, patients are not always aware they have a heart rhythm disorder. Thankfully, diagnostics have changed tremendously. Take wearables; many people come see me because their smartwatch has told them that their heart is beating abnormally.”
If, after further tests, a heart rhythm disorder is confirmed, a consultant will guide the patient through available treatment options. This might include the fitting of a leadless pacemaker, a device primarily used for slow heart rhythms like bradycardia or heart block, where electrical signals are partially or completely blocked, slowing heart rate.
Early detection prevents potentially devastating consequences
Advantages of leadless pacemaker technology
Recent advances to this nearly 70-year-old technology are significantly improving patient care. “A conventional pacemaker uses wires, or leads, to connect a pulse generator the size of a matchbox to the heart muscle,” explains Professor Wong. “However, leadless pacemakers are an innovation which may be suitable for some patients. These are much smaller, don’t have wires and can be placed inside the heart in a minimally invasive way. Long-term benefits include fewer lead-related complications, greater comfort and durability.”
Unlike a conventional pacemaker, there is no generator, which, in rare cases, can cause infection. Plus, because there are no wires, there is no issue with wire fracture. Developments to the technology keep coming, including smaller devices and longer battery life. In 2024, Royal Brompton Hospital and St Thomas’ Hospital carried out the UK’s first leadless dual-chamber pacemaker implant, where two devices in the heart communicate with one another wirelessly.
Wider impact for patients
Rapid innovation includes dual-chamber systems, improved battery technology, physiologic pacing and advanced communication capabilities. The result: more effective, patient-friendly cardiac rhythm management.
“In conjunction with our partners at Imperial College London and King’s College London, we continue to push the boundaries of cardiac therapy with evidence-based research,” says Professor Wong. “This work helps us, and other centres, understand how best to utilise pacemaker technology, informing healthcare guidelines and, importantly, improving patient care.”
[1] Arrhythmias. Heart Research UK. https://tinyurl.com/y7vbzr33
