Abstract
BackgroundCardiac pacing has been shown to improve quality of life and prognosis of patients with bradycardia for almost 60 years. The latest innovation in pacemaker therapy was miniaturization of generators to allow leadless pacing directly in the right ventricle. There is a long history and extensive experience of leadless ventricular pacing in Austria. However, no recommendations of national or international societies for indications and implantation of leadless opposed to transvenous pacing systems have been published so far.ResultsA national expert panel of skilled implanters gives an overview on the two utilized leadless cardiac pacing systems and highlights clinical advantages as well as current knowledge of performance and complication rates of leadless pacing. Furthermore, a national consensus for Austria is presented, based on recent studies and current know-how, specifically including indications for leadless pacing, management of infection, suggestions for qualification, and training of the operators and technical standards.ConclusionsLeadless pacing systems can be implanted successfully with a low complication rate, if suggestions for indications and technical requirements are followed.Condensed abstractAn overview of the two utilized leadless cardiac pacing systems is given, specifically highlighting clinical advantages as well as current knowledge of performance and complication rates. Furthermore, a national consensus for Austria is presented, specifically including indications for leadless pacing, management of infection, and suggestions for qualification and technical standards.
Highlights
Cardiac pacing has been shown to improve quality of life and prognosis of patients with bradycardia for almost 60 years
The authors concluded that the results demonstrate consistency with the results of the Micra Transcatheter Pacing Study and highlight the advantages of a leadless pacemaker (LP) in reducing complications associated with the components of conventional pacemakers
Possible candidate for LP implantation: - Suitable for a LP according to underlying arrhythmia - Two or more clinical risk factors for device infection: diabetes mellitus, renal dysfunction or chronic hemodialysis, chronic use of corticosteroids, recurrent systemic infections, or immunosuppressive therapy developing a first event and those after explantation of a cardiac implantable electronic devices (CIED) for severe infection
Summary
Leadless pacing systems can be implanted successfully with a low complication rate, if suggestions for indications and technical requirements are followed. Condensed abstract An overview of the two utilized leadless cardiac pacing systems is given, highlighting clinical advantages as well as current knowledge of performance and complication rates. A national consensus for Austria is presented, including indications for leadless pacing, management of infection, and suggestions for qualification and technical standards.
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