Salinas >> Dwight “Butch” Johnson Jr. walked out of the hospital doors last month only 10 hours after he entered Salinas Valley Memorial Hospital to have the world’s smallest pacemaker implanted.
But not before he ran four laps around the hospital hallways, the nurses trailing behind him.
“They weren’t keeping up with him,” said Kathy Johnson, his wife.
Butch Johnson became one of the first people in California, and the first in Monterey County, to receive the Micra Transcatheter Pacing System or TPS, a state-of-the-art pacemaker about the size of a large vitamin and weighing no more than a penny. It’s designed so all components are placed directly on the heart. No wires, no clunky battery/computer box, no discomfort.
“We partner with our physicians to provide the most advanced technology available,” said Pete Delgado, president/CEO of Salinas Valley Memorial Health System, in a press release. “Our hospital was chosen to be among the first in the state to provide this breakthrough medical device to patients who can benefit from the technology.”
Johnson isn’t your average 67-year-old: An All-American triathlete, each week he swims 3 miles, bikes another 20, lifts weights at the gym and cools down by kayaking around Elkhorn Slough.
His routine may not resonate with most — even those with young hearts — but his heart condition of atrial fibrillation does. Atrial fibrillation is a condition where the heart skips a beat and the Center for Disease Control estimates between 2.7 and 6.1 million people in the United States had the condition in 2014.
In Johnson’s case, his heart skipped 14,000 times in two days — sometimes for seven seconds. He knew a pacemaker was in his future, but a traditional pacemaker can be a nuisance, especially for someone with an active lifestyle.
“It physically gets in the way,” said Harlan Grogin, the physician at Salinas Valley who performed Johnson’s surgery. “Whether a patient is swimming or golfing, it just bothers them” because of its location under the collarbone.
Rather than remotely connected by wires shimmied through a vein to the heart, the TPS pacemaker sits directly on the heart. That, in addition to the surgery requiring nothing more than a small slit on the inside of your leg, means it’s not even noticeable.
“There are no physical restrictions of any kind,” said Johnson.
But according to Grogin, the design isn’t just great for athletes.
“It’s attractive for patients who would benefit from a traditional one-wire pacemaker, but for some reason don’t have access to put a traditional pacemaker in its usual location,” he said.
Often that’s because the vein is no longer present, such as in a breast cancer patient after a breast is removed, cancer patients with a permanent IV in the vein and those who developed infections from traditional pacemaker wires.
According to Grogin, the risk of infection from the TPS is minimal. “With something in the heart, after about 30 days to two months … the pacemaker will be covered with tissue,” he says, encapsulating the device. “Once it’s encapsulated, the risk of infection is extremely low as time goes on.”
Each pacemaker lasts for 10 to 12 years, twice as long as a traditional pacemaker, and patients may receive up to three.
“I think this pacemaker’s going to be great for all the athletes out there that are like me,” Johnson said. “They’re going to have a chance to put this pacemaker in and keep doing it until they’re 80, 90, 100.”
For him, that means at least another 30 years of running, biking, kayaking and scuba diving.
“Well, the doctor did say don’t do bungee jumping,” noted his wife, Kathy.
“Right, so no more bungee jumping,” Butch agreed.