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World’s Smallest Pacemaker Keeps Cancer Patient’s Heart Issues at Bay

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Dolores Van Vorst with Dr. Jason Rytlewski who is holding the world's smallest pacemaker.

Dolores Van Vorst has a feisty side. Maybe it’s because she grew up in Brooklyn, NY. Or maybe it’s because she was a stay-at-home mother who raised six children. Either way, the 79-year-old’s lively spirit has helped her to stay positive through multiple health issues. 

Twenty years ago, Van Vorst’s health began to decline. A failed hip replacement, later combined with knee issues, ultimately confined her to a wheelchair. Then last year she was diagnosed with breast cancer. 

One day last fall, after receiving chemotherapy at Wake Forest Baptist Medical Center, Van Vorst became dizzy while trying to get out of her hospital bed. The dizziness was foreign to her. When her heart monitor went off, the nurse rushed in to help her back in bed.

As it turns out, the chemotherapy had depleted Van Vorst’s body of magnesium and calcium, slowing her heart rate to a dangerous level.

“It’s a good thing the arrhythmia team was here,” Van Vorst later said.

But the onset of a heart issue while being treated for breast cancer posed a unique problem for Van Vorst’s care team. They needed to find a solution that wouldn’t interfere with future cancer treatments.

Fixing a Heart Problem

Dr. Jason Rytlewski, electrophysiologist at Wake Forest Baptist, said Van Vorst was suffering from bradycardia, a slowing of the heart rate that causes dizziness, fainting spells and can result in heart failure.

Traditionally, in order to regulate heart rate, pacemakers are implanted under the skin near the collarbone. Lead wires are then connected from the device to the heart.

But traditional pacemakers can interfere with chemotherapy or radiation treatments; they also typically prevent patients from receiving MRIs.

Dr. Rytlewski and the Wake Forest Baptist electrophysiology team decided Van Vorst was a perfect candidate for the new Medtronic Micra Transcatheter Pacing System. She was the first person in Western North Carolina to receive the Micra device.

The world’s smallest pacemaker, the Micra is about the size of a large vitamin – less than one-10th the size of a standard pacemaker. The device is made for bradycardia arrhythmias, and specifically benefits patients such as Van Vorst, who need additional treatments for other health issues.

The battery-powered Micra is implanted directly into the heart and does not require lead wires so there’s no interference with other treatments or the ability to perform an MRI. 

“Slow heartbeat is increasingly common as people age, and it can be compounded by medications used to treat other problems, such as blood pressure medication,” said Dr. Patrick Whalen, director of cardiac electrophysiology at Wake Forest Baptist. “The Micra and devices like it will change how we treat patients with slow heartbeats in the future.”

Noticing a Difference

Months later, Van Vorst said her new pacemaker works great. Although she continues to receive treatment for breast cancer, she has not experienced any dizziness since that day in the hospital.

“There aren’t too many of us from Brooklyn around here,” she said. “I keep telling the doctors, ‘Don’t worry about me. I rode the subways since I was a child and if you can do that and survive, hey, you’re good to go.’”

Learn more about the Micra Leadless Pacemaker.

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Last Updated: 03-06-2017
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