Leadless cardiac stimulation – future or fiction?

Czech version

Authors: P. Neužil
Authors‘ workplace: Kardiocentrum Nemocnice Na Homolce, Praha
Published in: Kardiol Rev Int Med 2015, 17(3): 194-201
Category: Cardiology Review

Overview

For several decades, the traditional transvenous approach to permanent cardiac pacing has been accepted as the gold standard approach to the treatment of patients with bradycardias. However, it can be associated with significant acute and chronic complications related partly to either the insertion of the transvenous lead or subcutaneous placement of the pacemaker device. We summarise the current results of novel self‑ contained leadless cardiac pacemakers in the first‑ in‑man and subsequent series of feasibility studies in patients indicated for ventricular rate‑ responsive pacing (VVI). Using a femoral venous approach, the device is implanted in the right ventricular apical septum region. We describe the technical and clinical characterisation of this innovative technology. Two different systems of leadless pacemakers are currently implanted in patients. Up to now, the electrical parameters, such as pacing thresholds, sensing parameters, and pacing impedances, either improved or remained stable within the accepted range. We also discuss the potential benefit for the future of permanent cardiac stimulation, but in summary, all available data demonstrate the feasibility of leadless cardiac pacing.

Keywords:
permanent cardiac pacing – self‑ contained leadless cardiac pacemaker – miniaturisation

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