In what represents one of the most significant advances for the Hospital Universitario Nacional (HUN), the healthcare center implanted for the first time one of the smallest pacemakers in the world. The characteristics of the device, measuring only a few centimeters, reduce the risk of infection and complications in patients with chronic diseases and complex clinical histories.
One of its main advantages is that it integrates the electrode, the battery, and the electronic circuits responsible for stimulating the heart, reducing external components and possible failures associated with the conventional system. “Unlike conventional pacemakers, the Micra does not require leads or a generator under the skin of the chest,” explained cardiologist Gabriel Arsenio Londoño Zapata, electrophysiologist at the HUN, cited in a bulletin from the UNAL News Agency.
Without leads and without a ‘surgical pocket’
“The main advantage of this technology is that it eliminates two of the points where complications most often occur: the leads that connect the device to the heart and the ‘surgical pocket’, a space created under the skin of the chest to house the pacemaker generator; this is one of the most important benefits, since complications and infections often arise there,” the specialist added.
Another advantage is that, with the new technology, the procedure is performed via the endovascular route, inserting a catheter through the femoral vein until it reaches the heart. There, the device is released inside the right ventricle and the entire access system is then removed. “No leads or large wounds remain, and there is also no visible device under the skin. The only mark is the puncture site where the catheter entered,” explained Dr. Londoño Zapata.
In contrast, conventional pacemakers must be implanted through an incision in the chest to create a pocket under the skin in which the generator is placed. In addition, they are connected to the heart through leads. Although this is a widely used technique, it can cause complications in people with wound-healing problems, immunosuppression, or recurrent infections.
Likewise, while traditional pacemakers usually require temporary restrictions on arm movement, the leadless system allows for a faster recovery. “After the first 12 to 24 hours of care, the patient can return to their normal life more easily,” the specialist added.
Technology for high-complexity cases
On the other hand, according to the cardiologist, international studies show a reduction of up to 50% in complications associated with traditional pacemakers, especially those related to leads and the subcutaneous generator.
Although the use of leadless pacemakers has been increasing in Colombia and around the world, specialists agree that it remains a technology intended for carefully selected patients due to its complexity and cost. In 2025, the HUN implanted 51 conventional pacemakers, and so far in 2026, 31 procedures of this type have already been performed.
Juan Felipe Betancourt, a physician specialized in clinical cardiac electrophysiology, who accompanied the procedure as an expert proctor in Colombia for Medtronic (a leading U.S. biomedical device company), explained, also cited by the UNAL News Agency, that the system is designed especially for people who do not adequately tolerate traditional pacemakers.
“Some patients have problems with the leads or with the subcutaneous pocket, or present a high risk of infection, as well as patients with chronic kidney disease on hemodialysis, or those who have venous obstructions that make conventional access to the heart difficult,” he noted, and highlighted that Colombia has become one of the leading countries in South America in the implantation of this type of device.
“This is the country that has implanted the most pacemakers of this type in South America, even ahead of countries with larger populations such as Brazil or Mexico,” he said.