Leadless Intracardiac Transcatheter Pacing System

Abstract

Cardiac pacemakers are limited by device-related complications, notably infection and problems related to pacemaker leads. Innovative product development eliminates pacing leads by stimulating the heart through wireless transmission of energy. A tiny, wireless heart pacemaker showed promise in early tests and could offer an alternative to conventional, wired pacemakers. Unlike traditional pacemakers-which need a generator and wires and are implanted via surgery-the new pacemaker is a wireless tiny tube that can be attached to the right side of the heart using a catheter inserted through the leg. While most pacemakers have wires connecting the device to the right and left sides of the heart, the new device sits in the right ventricle and doesn't coordinate the two sides. The mini pacemaker is the size of a large pill and can be placed without surgery. Two leadless pacemakers, the Micra Transcatheter Pacing System (TPS) (Medtronic) and the Nanostim (St. Jude Medical), are currently in development. Each consists of a self-contained intracardiac device including the pacemaker, electronic circuits, battery, and leads(1). It has a low rate of complications compared to traditional pacemakers. Wireless pacemaker is now primarily intended for a small portion of patients who have an abnormal heart rhythm known as long-lasting persistent atrial fibrillation, plus a slow heartbeat. It may also be the only technology for kidney failure patients on dialysis or patients who have chronic blood vessel infections.