Leadless pacemakers: The leap from single to dual chamber pacing

Abstract

Leadless pacemaker (LP) systems are an important, major evolution in cardiac pacing therapy. As self-contained devices, they are implanted directly into the cardiac chamber without the need for transvenous leads or a generator pocket. Hence, they have the advantages of a lower susceptibility to infection and minimized vascular complications. Through experience with the currently available single chamber devices, we have learned that these can be implanted successfully in the majority and that chronic pacing performance and battery longevity are reliable at least in the medium term. 1 El-Chami M.F. Bockstedt L. Longacre C. et al. Leadless vs. transvenous single-chamber ventricular pacing in the Micra CED study: 2-year follow-up. Eur Heart J. 2022; 43: 1207-1215 Crossref PubMed Scopus (32) Google Scholar The 2021 European Society of Cardiology guidelines now recommend LPs when no upper extremity venous access is available or when there is a high risk of infection (class 2a indication) and as an alternative to single chamber pacing depending on life expectancy and shared decision making (class 2b indication). 2 Glikson M. Nielsen J.C. Kronborg M.B. et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021; 42: 3427-3520 Crossref PubMed Scopus (519) Google Scholar Dual-chamber leadless pacing: Atrioventricular synchrony in preclinical models of normal or blocked atrioventricular conductionHeart RhythmPreviewDual-chamber leadless pacemakers (LPs) require robust communication between distinct right atrial (RA) and right ventricular (RV) LPs to achieve atrioventricular (AV) synchrony. Full-Text PDF