A 72-year-old Portland woman has resumed her active lifestyle — tending to her large garden, spending time with her family and more — after being the first person in Oregon to receive a wireless, dual-chamber pacemaker.
Oregon Health & Science University surgeons implanted an AveirTM DR pacemaker system into the heart of retired psychiatrist Valerie Clappison, M.D., on Feb. 28. She was able to leave the hospital the next day and returned to her typical activities soon afterward.
This marks Clappison’s sixth pacemaker; her first was implanted in 2000. Each of her pacemakers have helped her overcome slow heart beats, which she has experienced since she was diagnosed with multiple sclerosis at age 45.
“I am very happy,” Clappison said. Unlike the new model, her previous pacemakers had wires, making them more obtrusive. “I keep thinking that I’m missing something. And then I realize that the big lump on my chest, where my last pacemaker used to be, is gone.”
The future
Pacemakers correct slow or irregular heartbeats by sending electrical pulses to control heart muscle contractions. As many as 3 million Americans are living with pacemakers, according to a publication by the healthcare education company StatPearls.
Unlike traditional pacemakers, wireless pacemakers are implanted directly into the heart. Wireless pacemakers don’t need thin wires, or leads, to connect a pulse generator with the heart. Not having wires reduces potential complications. And, because wired pacemakers are implanted under the collarbone, wireless pacemakers also have the extra benefit of not leaving a lump on the chest.
The Food and Drug Administration approved the first wireless pacemaker in 2016, but that device was designed to be inserted into a single heart chamber. About 80% of patients who need a pacemaker require a device that controls two heart chambers.
Made by the medical device company Abbott, the AveirTM DR pacemaker system was approved by the FDA in June 2023.The system consists of two capsules that are each smaller than a AAA battery. They are placed inside the heart through a catheter, which is inserted through a vein near the groin. One capsule goes in the heart’s upper right chamber, and the other is placed inside the heart’s lower right chamber. The two pieces communicate with each other to coordinate contractions in each chamber, helping push blood through the heart and throughout the body.
“Leadless pacing is the where the field of pacemakers is going,” said Charles Henrikson, M.D., a professor of medicine (cardiovascular medicine) in the OHSU School of Medicine and the OHSU Knight Cardiovascular Institute cardiac electrophysiologist who treats Clappison’s irregular heartbeats.
'Grateful'
Clappison’s new, wireless pacemaker provides a much-needed upgrade from her last device. Perhaps because she leads an active life and is petite, the most recent pacemaker began moving toward her armpit after it was implanted, causing discomfort and limiting her movement during everyday tasks, like raking leaves and pruning trees. The old pacemaker’s unintended position also meant it sometimes didn’t generate electrical pulses when it should, and often made Clappison feel faint.
Having a wireless pacemaker also means Clappison won’t have more wires left in her chest if she ever needs to replace her current device. When replacing a traditional pacemaker, physicians often only remove the pulse generator and allow the old wires to remain. This is because traditional pacemaker wires become embedded with a patient’s veins over time, and removing the wires can cause unintentional damage. However, some of the complications that patients with pacemakers can experience involve the wires, including veins becoming obstructed by scar tissue or a blood clot that develops near a wire.
Clappison is becoming familiar with her new pacemaker, which she says delivers “more subtle” electrical pulses than her previous devices. She’s also enjoying putting it through its paces: During a recent workout at the gym, she was pleased to feel her heart rate get up to 130 beats per minute.
Now that’s she back on her feet, Clappison and her husband are also again hosting their family’s weekly Sunday meal, where they enjoy the company of their children and grandchildren.
The pacemaker is also enabling her to spend more time tending to her beloved, lush garden, where everything from vegetables and fruit to flowers and trees grow readily on her southwest Portland home’s 1-acre plot. The garden has provided solace as she’s confronted the many ups and downs of having multiple sclerosis.
“There have been some pretty difficult times over the years, and the garden has kept me alive throughout it all,” Clappison said. “I’m grateful to be able to grow more plants from seeds in our greenhouse, and then see them flourish outdoors.”
Since Clappison’s Feb. 28 procedure, four other patients have received a wireless, dual-chamber pacemaker at OHSU. OHSU is the only hospital between Seattle and Burbank, California, that currently offers the system.
Patients who are interested in learning more about irregular heartbeat care can visit the OHSU Knight Cardiovascular Institute’s Arrhythmias and Heart Rhythm website.
To see how the AveirTM DR pacemaker system works, watch Abbott's short animation video.