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A two-month-old baby is thriving after receiving the world’s smallest pacemaker late last year. According to doctors, Mikey Oliveri was born prematurely and weighed just 2.5 kg and had his life saved by this tiny device after he was diagnosed with heart block, a dangerous condition.
Doctors at New York’s Hassenfeld Children’s Hospital at NYU Langone said Mikey’s mother, Sarah, despite presenting well until 20 weeks, had an exam indicating signs of heart block—a rare heart condition that is congenital and disrupts the heart’s electrical system, preventing the normal signal to pump blood from reaching the lower chambers and causing a slow or irregular heartbeat.
After the diagnosis was confirmed, Mikey’s heart was closely monitored with a heart rate that was in the mid-50s in utero, well below the typical newborn rate of 130 to 150 beats per minute. “After delivery on December 5, Mikey’s heart rate dropped below 50, and signs of distress emerged,” said Dr. Reina Tan, Mikey’s pediatric cardiologist and electrophysiologist.
“We determined he would need a pacemaker as soon as possible.”
The pacemaker is the size of a large vitamin capsule
Doctors said babies who need pacemakers must weigh at least 3-3.5 kilograms before they can receive a standard device, but since Mikey was far too small and could not wait to reach that weight, they had to do something to save his life.
Dr. Tan and her team got a tiny, leadless pacemaker from Medtronic’s Micra no bigger than a large vitamin capsule, which weighed about as much as a penny. The device was specially adapted for Mikey, transforming it into a version where it could be used as a pacemaker generator after pacing leads were attached to his heart.
Even though usage of pacemakers is common in adults, they are rarely put in children—especially in newborns. Only 1 in 20,000 children are born with heart block each year, and not all of them require a pacemaker. “This is a unique situation,” said Dr. Tan. “Mikey is only 1 of 52 babies in the United States to receive this kind of pacemaker. He’s the first baby at NYU Langone and the first in the tri-state area.”
After the surgery, Mikey stayed in the hospital for two weeks and received antibiotics to ward off any infection. Earlier this year, he was discharged and since then has been recuperating and leading a normal baby life.
What is a heart block?
According to experts, heart block is an issue with a heartbeat signal travelling from the top chambers of your heart to the bottom chambers of your heart. Normally, the impulses or electrical signals travel from your heart’s upper chambers to the lower ones and the signal moves along, linking the electrical activity from your top to bottom chambers. But if there is a block, the signal only makes it to your ventricles some of the time, if at all.
For those with the condition, the heart may not work well. Your heart may beat slowly or skip beats. In severe cases, heart block affects your heart’s ability to pump blood, causing low blood flow to your entire body.
Mostly, people acquire heart block later in life than have it at birth.
What causes heart block?
A few reasons anyone would have a heart block include:
- Heart attack
- Coronary artery disease
- Heart muscle disease
- Issues with your heart’s structure since birth
- Heart damage during surgery
- Side effects from medication like beta blockers
- Exposure to toxins
- Obstructive sleep apnea
- Thyroid
- Autoimmune diseases
- Genetic anomalies
Signs and symptoms of heart block
- Chest pain
- Tiredness
- Breathlessness
- Palpitations
- Rapid breathing
- Nausea
- Dizziness and fainting
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