Calgary emerges as training hub for advanced pacemaker

A Calgary cardiologist and medical research leader says more Canadians are benefiting from an innovative new pacemaker following recent Health Canada approval.

Dr. Derek Exner, MD, cardiologist and heart rhythm specialist with Alberta Health Services (AHS) and associate dean of innovation and commercialization at the Cumming School of Medicine (CSM), has been at the forefront of developing a miniaturized pacemaker. Health Canada approved the Abbott AVEIR technology in May after nearly a decade of brainstorming, research and clinical trials, allowing the device to be used in Canadian patients beyond a clinical research program.

“The approval is a game changer in cardiovascular care and improved care for Canadians. It allows Canadians access to this new pacemaker technology, and that means improved quality of life,” says Exner.

Exner led Canadian and Australian teams involved in an international study evaluating the effectiveness of the devices. Foothills Medical Centre (FMC) was one of 55 locations worldwide, including three in Canada. The research team has worked with global health-care company Abbott since 2014.

“One of the truly amazing things is patients forget that they have a pacemaker,” says Exner. “That’s really rewarding, taking the device from a place where its a slight inconvenience to a place where they forget they have it.”

‘It’s kinda boring, actually’

Gord Kirk, 68, started noticing his heart beating irregularly in the late 1980s. Over the years, the fit and active Calgarian says his heart rate slowed to the point his resting heart rate was so low that he would get dizzy spells and often felt faint when he stood up or moved suddenly. His doctor referred him to a cardiologist. By February 2021, he was all set for a conventional pacemaker. That’s when he got a phone call from Exner.

“Dr. Exner said I was a candidate for a clinical trial. When he explained the device to me and what it offered, I saw only upside,” says Kirk. “I didn’t even know there was such a thing as a leadless pacemaker.

“It’s kinda boring, actually. It’s been great and I don’t feel any of the symptoms I used to — the lightheaded spells and dizziness. It’s just back to normal. I go days without even thinking about it.”

What is a leadless pacemaker?

A pacemaker keeps a person’s heartbeat from going too slow and helps regulate heart rhythm by sending a tiny electric signal to the heart, causing it to beat. “Leadless” means the pacemaker doesn’t have wires connecting it to a person’s bloodstream and then to their heart. 

Smaller than a AAA battery, the Abbott AVEIR leadless pacemaker is much smaller than traditional pacemakers — around three quarters the size of a AAA battery. It is easier to implant and replace, with a surprisingly longer battery life, averaging more than 15 years. Shaped like the tip of a pen, it is also less invasive, inserted through a small incision in the groin and guided into the right lower heart chamber.

The work done by UCalgary and AHS researchers over the years has been accelerated by philanthropy, with support from the Calgary Health Foundation helping to build the specialized operating theatre needed to move forward with the clinical trial and provide the technology to Albertans.

The first implantation of the Abbott AVEIR leadless pacemaker device took place in Calgary in November 2020. The research is a success story for UCalgary’s drive for impact in commercialization, with support coming from the Life Sciences Innovation Hub and Innovate Calgary.

Exner expects the pacemaker research to continue at UCalgary. In partnership with AHS, FMC has become a regional and international training centre, helping other physicians to learn about the breakthrough device and receive training required to provide the technology to future patients.  

February is Heart Month, a great time to raise awareness of the importance of cardiovascular health and what we can do to reduce our risk of cardiovascular disease. Heart disease affects approximately 2.4 million Canadian adults and is the second leading cause of death in Canada. More than 200,000 Canadians currently live with a pacemaker.