Introduction to Tiny Pacemakers

Engineers at Northwestern University have developed a tiny pacemaker, smaller than a grain of rice, which could play a significant role in the future of medicine. The device, unveiled in a study published in the peer-reviewed journal Nature, is the smallest pacemaker in the world and has the potential to be used in both infants and adults.

The Need for Tiny Pacemakers

Researchers were initially inspired to create the device for infants with congenital heart defects. About 40,000 babies in the U.S. are born with heart defects each year, and approximately a fourth of those require surgery or other procedures in their first year of life. After surgery, these infants typically need a pacemaker for about a week while their hearts heal. Some adults also require temporary pacemakers, such as after an aortic valve replacement or bypass surgery.

How the Tiny Pacemaker Works

The device can be inserted with a catheter or syringe and is paired with another small, patch-like device worn on the patient’s chest. When the device on the chest detects irregular heartbeats, it emits pulses of light into the chest that activate the pacemaker, delivering electrical stimulation to the heart. The pacemaker is designed for patients who need a pacemaker only temporarily and dissolves into the patient’s body once it’s no longer needed.

Benefits of the Tiny Pacemaker

The tiny pacemaker has several benefits over traditional pacemakers. It is fully implantable, reducing the risk of infection, and it is transient, meaning it serves a purpose for a specific number of days or weeks and then dissolves. This eliminates the need for surgical removal, which can introduce complications such as bleeding, damage to the heart muscle, and infection.

Testing and Development

The paper published in Nature showed how researchers have used the small, implantable device in mice, rats, a dog, and in hearts from deceased humans and pigs. Eventually, the team hopes to get approval from the U.S. Food and Drug Administration to begin clinical trials in humans. The researchers have co-founded a company called NuSera Biosystems to further develop the device and bring it to market.

Expert Opinion

Dr. Gaurav Upadhyay, an electrophysiologist and associate professor of medicine at the University of Chicago, called the study "exciting" and noted that the new pacemaker is "impressively smaller than anything else we have available." Upadhyay believes that if the device can be confirmed in clinical trials, it will have incredible applications for short-term pacing requirements and can be used in a variety of clinical settings.

Conclusion

The development of the tiny pacemaker is a significant breakthrough in medical technology. Its small size, implantability, and transient nature make it an attractive option for patients who require temporary pacing. While the device is still in the early stages of development, it has the potential to revolutionize the treatment of heart defects and other conditions that require pacemakers.

FAQs

• Q: How small is the tiny pacemaker?
• A: The tiny pacemaker is smaller than a grain of rice.
• Q: Who can benefit from the tiny pacemaker?
• A: Infants with congenital heart defects and adults who require temporary pacemakers can benefit from the device.
• Q: How is the tiny pacemaker inserted?
• A: The device can be inserted with a catheter or syringe.
• Q: What are the benefits of the tiny pacemaker?
• A: The device is fully implantable, reducing the risk of infection, and it is transient, meaning it serves a purpose for a specific number of days or weeks and then dissolves.
• Q: When can we expect the tiny pacemaker to be available for human use?
• A: The device is still in the early stages of development, and the researchers hope to begin clinical trials in humans in the future.
  

  A new, tiny pacemaker — smaller than a grain of rice — developed at Northwestern University could play a sizable role in the future of medicine, according to the engineers who developed it.

  Researchers unveiled the device, which they say is the smallest pacemaker in the world, in a study published Wednesday in the peer-reviewed journal Nature.

  Though the device is still years away from being used in humans, it could eventually be useful for infants with congenital heart defects and also for adults, the researchers say.

  “I think it’s really exciting technology that will change how electrical stimulation is done,” said Igor Efimov, a Northwestern experimental cardiologist who co-led the study.

The device can be inserted with a catheter or syringe. After it is placed in or on the heart, it’s paired with another small, patch-like device worn on the patient’s chest. When the device on the chest detects irregular heartbeats it emits pulses of light into the chest that activate the pacemaker, delivering electrical stimulation to the heart.

The device is designed for patients who need a pacemaker only temporarily. It dissolves into the patient’s body once it’s no longer needed.

Engineers were initially inspired to create the device for infants with congenital heart defects. About 40,000 babies in the U.S. are born with heart defects each year, and about a fourth of those “generally need surgery or other procedures in their first year of life,” according to the Centers for Disease Control and Prevention. After surgery, the infants typically need a pacemaker for about a week while their hearts heal.

Northwestern engineers unveiled what they say is the smallest pacemaker in the world. Though the device is still years away from being used in humans, it could eventually be useful for infants with congenital heart defects, as well as adults, the researchers say. The pacemaker can be inserted with a catheter or syringe. (John A. Rogers/Northwestern University/TNS)

Some adults also need temporary pacemakers, such as after an aortic valve replacement or bypass surgery, Efimov said.

In such cases, surgeons now must often sew a wire onto the heart that’s attached to an external box that delivers a current to control the heart’s rhythm. When the pacemaker is no longer needed, surgeons must remove the wire from the heart, which can introduce complications such as bleeding, damage to the heart muscle and infection.

Such a complication contributed to the death of astronaut Neil Armstrong in 2012, when he started bleeding internally as wires of a temporary pacemaker were being removed, the New York Times reported.

“Even though it’s exceedingly rare, it could be lethal,” Efimov said of complications of removing traditional, temporary pacemakers. “We wanted to create a pacemaker which would be, first of all, much, much smaller compared to what it is now, fully implantable so there’s nothing external, so there’s no risk of infections, but more importantly, it’s transient. It serves a purpose for whatever number of days or weeks it’s required, and after that it will dissolve.”

The paper published Wednesday showed how researchers have used the small, implantable device so far in mice, rats, a dog and in hearts from deceased humans and pigs.

Eventually, the team hopes to get approval from the U.S. Food and Drug Administration to begin clinical trials in humans. Efimov and Northwestern bioelectrics expert John Rogers, who co-authored the study and led development of the device, co-founded a company at Northwestern called NuSera Biosystems that will work to further develop the device and eventually bring it to market.

Dr. Gaurav Upadhyay, an electrophysiologist and associate professor of medicine at the University of Chicago, called the study “exciting.” Upadhyay was not involved in the device’s development or the study.

The new pacemaker is “impressively smaller than anything else we have available,” Upadhyay said. “If this can be confirmed in clinical trials, I think that there are incredible applications for short-term pacing requirements, which will have the potential to be used in a variety of clinical settings.”

        <p>Originally Published: April 9, 2025 at 1:00 PM EDT</p>