World’s Smallest Pacemaker, Tinier Than Rice Grain

Northwestern University scientists have created the world’s tiniest pacemaker, small enough to fit into a syringe tip and inject directly into the body without surgery. Measuring only 1.8 mm wide, 3.5 mm long, and 1 mm thick, the device is even smaller than a grain of rice, yet it delivers the same level of stimulation as a standard-sized pacemaker.

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“We have developed what is, to our knowledge, the world’s smallest pacemaker,” said Northwestern bioelectronics pioneer John A Rogers, who led the device’s development.

“There’s a crucial need for temporary pacemakers in the context of pediatric heart surgeries, and that’s a use case where size miniaturisation is incredibly important. In terms of the device load on the body – the smaller, the better.”

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How does this device function?

Currently, temporary pacemakers require surgery to sew electrodes onto heart muscles with wires connecting to a powered device on the patient’s chest. Doctors pull out the wires when the device is no longer needed, though this process can sometimes cause damage.

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When in contact with surrounding biofluids, the electrodes form a battery. The resulting chemical reactions cause the electrical current to flow to stimulate the heart.

Doctors attach the pacemaker to a soft patch worn on the patient’s chest. The team used an infrared wavelength of light that penetrates deeply and safely into the body.

“If the patient’s heart rate drops below a certain rate, the wearable device detects the event and automatically activates a light-emitting diode. The light then flashes on and off at a rate that corresponds to the normal heart rate.”

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The US-led team of researchers behind the new device said they aimed to help the small minority of children born with congenital heart defects.

“Our main focus was children. Around one per cent are born with congenital heart defects, but most only need temporary pacing after surgery. In about seven days, their hearts self-repair,” said Northwestern cardiologist Igor Efimov.

“This tiny pacemaker can support them during that critical period, without requiring another surgery for removal.”