'World's smallest' pacemaker fitted for first time in England

Prof John Morgan (left) called the new device a "milestone for cardiac rhythm management in the UK"

The world's smallest pacemaker has been fitted inside the heart of a UK patient, medics have said.

The Micra Transcatheter Pacing System was fitted for the first time in England at Southampton General Hospital.
Consultant cardiologist Prof John Morgan said the procedure was a "landmark moment".
He said the device was "not much larger than an antibiotic pill" and was one tenth the size of traditional models.

A brief history of the pacemaker

• Electrical activity within the heart was discovered in the 1800s
• The first artificial pacemaker, built by Albert Hyman in 1932, was powered by a hand-cranked motor
• Post World War 2 smaller devices were pioneered, with some worn like a necklace
• In 1958 the first implanted pacemaker was given to Arne Larsson in Sweden, but the device failed after three hours
• Early pacemaker batteries had short lifetimes until Wilson Greatbatch pioneered long-life lithium batteries in the 1970s

Source: The Science Museum, London

Currently, pacemakers, which use electrical impulses to regulate the beating of the heart, are inserted under the skin and connected to the heart via a lead.

The lead carries electrical signals to correct slow or irregular heartbeats, but they can require replacement due to broken or dislodged wires.
The new device can be implanted directly in the heart and delivers electrical impulses from an electrode, removing the need for a lead.
Prof Morgan said: "In addition to the advantages of the device's size and wireless technology, the procedure reduces the risk of infection and extended recovery time associated with traditional, more invasive surgical pacemaker implants.
"This a big step forward in patient treatment and a milestone for cardiac rhythm management in the UK."

Analysis By Fergus Walsh, BBC Medical correspondent
This new technology has several potential advantages.
Most important is the absence of a wire or lead which carries the electrical impulse from conventional pacemakers to the heart. These wires can come under immense pressure and can be a source of complications.
Standard pacemakers are implanted under the skin in the chest which can be a potential infection risk. By contrast, the tiny pacemaker used in these trials is inserted via a catheter from the groin and sits in the heart.
At 26mm long and weighing 2g, the Micra TM used in Southampton can claim to be the world's smallest pacemaker.
Southampton General is the only UK hospital which is taking part in a global clinical trial of the device.
A patient in Austria was the first to have the device implanted in December 2013. A rival system called Nanostim from St Jude Medical is also undergoing trials. It is 41mm long.
A third technology under development by EBR Systems combines a pacemaker implanted under the skin which wirelessly sends ultrasound energy to a receiving electrode - about the size of a grain of rice - implanted in the left ventricle.

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Breast cancer survivors 'do not exercise enough'

Adults should exercise regularly, guidelines say

Exercise can aid recovery after breast cancer but many women are not active enough, a study suggests.

Being active is known to be beneficial but US researchers, writing in the journal Cancer, said they had found many women did too little.
Only a third met recommended activity levels.
UK breast cancer groups said women here also needed more support to keep active after having the disease.

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Although this study was conducted in America rather than the UK, the results suggest that women who have received a breast cancer diagnosis need better support to keep active”

Caroline Dalton, Breakthrough Breast Cancer

The American study looked at the pre and post-diagnosis exercise levels of 1,735 women aged 20-74 who had breast cancer between 2008 and 2011 in North Carolina.

In the US and the UK, adults are recommended to do at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity each week.
But this study found only 35% of women who had experienced breast cancer met the physical activity guidelines.
'Helps patients cope' In the UK, campaigners said women here also needed to exercise more.
Caroline Dalton, of Breakthrough Breast Cancer, said: "Physical activity after a breast cancer diagnosis has been shown to improve a patient's chances of survival and there is also some evidence that it may help to reduce the risk of breast cancer returning.
"Keeping active may also help patients cope, both during and after treatment, by improving general health and wellbeing."
She added: "Although this study was conducted in America rather than the UK, the results suggest that women who have received a breast cancer diagnosis need better support to keep active."
"There are no specific guidelines in place at the moment to tell us precisely how much physical activity is needed after a breast cancer diagnosis, but Breakthrough Breast Cancer suggests aiming for 3.5 hours per week, after checking with your treatment team to see what is appropriate for you."
Baroness Delyth Morgan, chief executive at Breast Cancer Campaign, said: "This study serves as a reminder of how important it is that women with breast cancer are made aware that physical activity can improve their chances of survival.
"Recent research has shown that even small increases to the amount of exercise done after a breast cancer diagnosis can give women a better chance of survival.
"This is why it is essential that women are given a clear written follow-up care plan, which should include practical advice about diet and exercise."

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Indian government announces rapid economic reforms

Food inflation is among the highest in the world

India's new government has unveiled a programme for rapid economic reforms aimed at creating jobs and boosting foreign investment.

The announcement by President Pranab Mukherjee included plans designed to simplify taxation and reduce inflation.
Industrial reforms included attracting private investment to the coal and defence sectors.
He also spoke of India's hopes for good relations with neighbours and pledged to tackle violence against women.
The President's parliamentary address was made to lawmakers elected in Prime Minister Narendra Modi's landslide victory last month.
Mr Mukherjee said that the government would introduce a general sales tax, encourage foreign investment and speed up approvals for major business projects. It would also tackle bottlenecks that make India's food inflation the highest among major economies.
The anti-inflationary message will be welcomed by central bank governor Raghuram Rajan, who has made lowering India's growth-stifling high interest rates contingent on containing consumer prices.
India's economic expansion has slowed markedly, growing by 4.7% in the 2013-14 financial year and marking the second year of sub-5% growth.

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