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Xu F, Meng L, Lin H, Xu W, Guo H, Peng F. Systematic review of leadless pacemaker. Acta Cardiol 2024; 79:284-294. [PMID: 37961771 DOI: 10.1080/00015385.2023.2276537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
Conventional pacing systems consist of a pacemaker and one or more leads threaded from the device pocket through veins into the heart conducting the pacing therapy to the desired pacing site. Although these devices are effective, approximately one in eight patients treated with these traditional pacing systems experiences a complication attributed to the pacemaker pocket or leads. With the technological advances in electronics, leadless pacemakers that small enough to implant within the heart were introduced. Leadless pacemakers have been developed to overcome many of the challenges of transvenous pacing including complications related to leads or pacemaker pockets. This review aims to provide an overview of advantages of leadless pacemaker, complications and limitations of leadless pacemaker, leadless pacemaker candidate, and future directions of this promising technology.
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Affiliation(s)
- Fukang Xu
- Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Liping Meng
- Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Hui Lin
- Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Weiyuan Xu
- Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Hangyuan Guo
- Shaoxing Wen li Medical College, Shaoxing, China
| | - Fang Peng
- Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
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2
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Beccarino N, Saleh M, Epstein LM. Leadless pacemakers: Where are we? Trends Cardiovasc Med 2024:S1050-1738(24)00018-5. [PMID: 38522582 DOI: 10.1016/j.tcm.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/10/2024] [Accepted: 03/10/2024] [Indexed: 03/26/2024]
Abstract
Pacemakers have been the cornerstone of brady-arrhythmia management since the mid-20th century. Despite the widespread use and success of traditional transvenous pacemakers, they are associated with an estimated 15 % complication rate at three years. Driven by the advantages over traditional transvenous pacemakers including a lack of transvenous leads, resistance to infection, and ease of implantation, the number of leadless pacemakers placed annually in the United States has dramatically increased since their initial approval. While current iterations of leadless pacemakers lack the versatility offered by transvenous devices, recent advances in leadless pacing offer an increasingly diverse range of therapeutic options. This review will discuss the past, present, and future emerging technologies, and strategies in leadless pacing.
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Affiliation(s)
- Nicholas Beccarino
- Department of Cardiology/Cardiac Surgery, Northwell Health. Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, 300 Community Drive, Manhasset 11030, NY, United States.
| | - Moussa Saleh
- Department of Cardiology/Cardiac Surgery, Northwell Health. Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, 300 Community Drive, Manhasset 11030, NY, United States
| | - Laurence M Epstein
- Department of Cardiology/Cardiac Surgery, Northwell Health. Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, 300 Community Drive, Manhasset 11030, NY, United States
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3
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Tanabe K, Gilliland S. Perioperative Considerations for Modern Leadless Pacemakers. Semin Cardiothorac Vasc Anesth 2024; 28:38-46. [PMID: 38284295 DOI: 10.1177/10892532241230368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Since their initial approval by the Food and Drug Administration in 2016, leadless pacemakers have become increasingly prevalent. This growth has been driven by an improved adverse effect profile when compared to traditional pacemakers, including lower rates of infection, as well as eliminated risk of pocket hematoma and lead complications. More recently, technology enabling leadless synchronized atrioventricular pacing in patients with atrioventricular block has vastly expanded the indications for these devices. Anesthesiologists will increasingly be relied upon to safely care for patients with leadless pacemakers undergoing non-electrophysiology procedures and surgery. This article provides an overview of the technology, evidence base, current indications, and unique perioperative considerations for leadless pacemakers.
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Affiliation(s)
- Kenji Tanabe
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Samuel Gilliland
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA
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4
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Bhatt HV, Fritz AV, Feinman JW, Subramani S, Malhotra AK, Townsley MM, Weiner MM, Sharma A, Teixeira MT, Lee J, Linganna RE, Waldron NH, Shapiro AB, Mckeon J, Hanada S, Ramakrishna H, Martin AK. The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights From 2023. J Cardiothorac Vasc Anesth 2024; 38:16-28. [PMID: 38040533 DOI: 10.1053/j.jvca.2023.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 12/03/2023]
Abstract
This special article is the 16th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series, namely the research highlights of the past year in the specialty of cardiothoracic and vascular anesthesiology. The major themes selected for 2023 are outlined in this introduction, and each highlight is reviewed in detail in the main article. The literature highlights in the specialty for 2023 begin with an update on perioperative rehabilitation in cardiothoracic surgery, with a focus on novel methods to best assess patients in the preoperative and postoperative periods, and the impact of rehabilitation on outcomes. The second major theme is focused on cardiac surgery, with the authors discussing new insights into inhaled pulmonary vasodilators, coronary revascularization surgery, and discussion of causes of coronary graft failure after surgery. The third theme is focused on cardiothoracic transplantation, with discussions focusing on bridge-to-transplantation strategies. The fourth theme is focused on mechanical circulatory support, with discussions focusing on both temporary and durable support. The fifth and final theme is an update on medical cardiology, with a focus on outcomes of invasive approaches to heart disease. The themes selected for this article are only a few of the diverse advances in the specialty during 2023. These highlights will inform the reader of key updates on various topics, leading to improved perioperative outcomes for patients with cardiothoracic and vascular disease.
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Affiliation(s)
- Himani V Bhatt
- Department of Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ashley Virginia Fritz
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Jared W Feinman
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sudhakar Subramani
- Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Anita K Malhotra
- Division of Cardiothoracic Anesthesiology and Critical Care, Penn State Hershey Medical Center, Hershey, PA
| | - Matthew M Townsley
- Department of Anesthesiology and Perioperative Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, AL; Bruno Pediatric Heart Center, Children's of Alabama, Birmingham, AL
| | - Menachem M Weiner
- Department of Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Archit Sharma
- Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Miguel T Teixeira
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Jennifer Lee
- Department of Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Regina E Linganna
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Nathan H Waldron
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Anna Bovill Shapiro
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - John Mckeon
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Satoshi Hanada
- Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Archer Kilbourne Martin
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL.
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5
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Clark BC, Berul CI. Emerging Technologies for the Smallest Patients. Card Electrophysiol Clin 2023; 15:505-513. [PMID: 37865523 DOI: 10.1016/j.ccep.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Pediatric and congenital heart disease patients may require cardiac implantable electronic device implantation, inclusive of pacemaker, ICD, and implantable cardiac monitor, for a variety of etiologies. While leads, generators, and monitors have decreased in size over the years, they remain less ideal for the smallest patients. The potential for a miniature pacemaker, fetal micropacemaker, improving leadless technology, and rechargeable devices creates hope that the development of pediatric-focused devices will increase. Further, alternative approaches that avoid the need for a transvenous or surgical approach may add more options to the toolbox for the pediatric and congenital electrophysiologist.
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Affiliation(s)
- Bradley C Clark
- Division of Pediatric Cardiology, Department of Pediatrics, Masonic Children's Hospital, University of Minnesota Medical School, 2450 Riverside Avenue South, AO-405, Minneapolis, MN 55454, USA.
| | - Charles I Berul
- Division of Cardiology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, 111 Michigan Avenue, NW, Washington, DC 20010, USA
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6
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Kaptein YE, Mortada ME. Implant-to-implant diagnostics and programming of dual-chamber leadless pacemaker in an orthotopic heart transplant recipient. HeartRhythm Case Rep 2023; 9:811-814. [PMID: 38023682 PMCID: PMC10667116 DOI: 10.1016/j.hrcr.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Affiliation(s)
- Yvonne E. Kaptein
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
| | - M. Eyman Mortada
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin
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7
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Banker RS, Rippy MK, Cooper N, Neužil P, Exner DV, Nair DG, Booth DF, Ligon D, Badie N, Krans M, Ando K, Knops RE, Ip JE, Doshi RN, Rashtian M, Reddy VY. Retrieval of Chronically Implanted Dual-chamber Leadless Pacemakers in an Ovine Model. Circ Arrhythm Electrophysiol 2023; 16:e012232. [PMID: 37767710 DOI: 10.1161/circep.123.012232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND The clinical utilization of leadless pacemakers (LPs) as an alternative to traditional transvenous pacemakers is likely to increase with the advent of dual-chamber LP systems. Since device retrieval to allow LP upgrade or replacement will become an important capability, the first such dual-chamber, helix-fixation LP system (Aveir DR; Abbott, Abbott Park, IL) was specifically designed to allow catheter-based retrieval. In this study, the preclinical performance and safety of retrieving chronically implanted dual-chamber LPs was evaluated. METHODS Atrial and ventricular LPs were implanted in the right atrial appendage and right ventricular apex of 9 healthy ovine subjects. After ≈2 years, the LPs were retrieved using a dedicated transvenous retrieval catheter (Aveir Retrieval Catheter; Abbott) by snaring, docking, and unscrewing from the myocardium. Comprehensive necropsy/histopathology studies were conducted to evaluate device- and procedure-related outcomes. RESULTS At a median of 1.9 years postimplant (range, 1.8-2.6), all 18 of 18 (100%) LPs were retrieved from 9 ovine subjects without complications. The median retrieval procedure duration for both LPs, from first-catheter-in to last-catheter-out, was 13.3 minutes (range, 2.5-36.4). Postretrieval, all right atrial, and right ventricular implant sites demonstrated minimal tissue disruption, with intact fibrous tissue limited to the distal device body. No significant device-related trauma, perforation, pericardial effusion, right heart or tricuspid valve injury, or chronic pulmonary thromboembolism were observed at necropsy. CONCLUSIONS This preclinical study demonstrated the safe and effective retrieval of chronically implanted, helix-fixation, dual-chamber LP systems, paving the way for clinical studies of LP retrieval.
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Affiliation(s)
| | | | | | - Petr Neužil
- Na Homolce Hospital, Prague, Czech Republic (P.N., V.Y.R.)
| | - Derek V Exner
- Libin Cardiovascular Institute of Alberta, Calgary, Canada (D.V.E.)
| | - Devi G Nair
- St. Bernards Healthcare, Jonesboro, AR (D.G.N.)
| | | | - David Ligon
- Abbott, Sylmar, CA (N.C., D.F.B., D.L., N.B., M.K.)
| | - Nima Badie
- Abbott, Sylmar, CA (N.C., D.F.B., D.L., N.B., M.K.)
| | - Mark Krans
- Abbott, Sylmar, CA (N.C., D.F.B., D.L., N.B., M.K.)
| | - Kenji Ando
- Kokura Memorial Hospital, Kitakyushu, Japan (K.A.)
| | | | - James E Ip
- Weill Cornell Medical Center, NY (J.E.I.)
| | | | | | - Vivek Y Reddy
- Na Homolce Hospital, Prague, Czech Republic (P.N., V.Y.R.)
- Icahn School of Medicine at Mount Sinai Hospital, NY (V.Y.R.)
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8
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Tan MC, Tan JL, Tay ST, Sorajja D, Scott L, Cha YM, Russo AM, Hussein A, Lee JZ. A Systematic Review of Short-Term Outcomes of Leadless Pacemaker Implantation After Transvenous Lead Removal of Infected Cardiac Implantable Electronic Device. Am J Cardiol 2023; 203:444-450. [PMID: 37542954 DOI: 10.1016/j.amjcard.2023.07.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/07/2023]
Abstract
The outcomes of leadless pacemaker (LP) implantation after transvenous lead removal (TLR) of infected cardiac implantable electronic devices (CIEDs) are not well-established. This study sought to describe the outcomes of LP implantation after TLR of infected CIED. We conducted a literature search using PubMed and Embase for a combination of terms including LP implantation, transvenous lead extraction, TLR, transvenous lead explant, infected CIED, infected pacemaker, and infected implantable cardioverter defibrillator. The inclusion criterion was LP implantation after TLR of infected CIED. The exclusion criterion was TLR for noninfectious reasons. Study end points included procedural complications and LP infection during follow-up. Of 132 publications reviewed, 13 studies with a total of 253 patients (74 ± 14 years of age, 174 [69%] males) were included. The most common indication of the initial device implantations was a high-degree atrioventricular block (n = 100 of 253, 39.5%). Of the 253 patients included, 105 patients (41.5%) underwent concomitant LP implantation during the TLR procedure, and 36 patients (14.2%) had temporary transvenous pacing as a bridge from TLR to LP implantation. Of the 148 patients with data on the type of CIED infection, 56.8% had systemic CIED infection and 43.2% had isolated pocket infection. Staphylococcus aureus was the most common causative organism in 33% of the reported patients. The LP was implanted an average of 5.4 ± 10.7 days after TLR of infected CIED. During the LP implantation, 1 patient (0.4%) had unsuccessful implantation because of an intraprocedural complication requiring sternotomy. After LP implantation, 2 patients (0.8%) developed groin hematoma, 2 patients (0.8%) developed femoral arteriovenous fistula, and 1 patient (0.4%) developed pericardial effusion requiring pericardiocentesis. During a mean follow-up of 11.3 ± 10.6 months, 3 patients (1.2%) developed pacemaker syndrome, 1 patient (0.4%) developed acute on chronic heart failure exacerbation, and only 1 patient (0.4%) developed LP-related infection requiring LP retrieval. This study suggests that LP implant is feasible and safe after removal of infected CIED with cumulative adverse events at 4% and a reinfection rate of 0.4%. Large prospective studies are needed to better evaluate the best timing of LP implantation after TLR of an infected CIED.
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Affiliation(s)
- Min Choon Tan
- Division of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona; Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, New Jersey
| | - Jian Liang Tan
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Soon Tzeh Tay
- Department of Medicine, School of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Dan Sorajja
- Division of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona
| | - Luis Scott
- Division of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona
| | - Yong-Mei Cha
- Division of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Andrea M Russo
- Division of Cardiovascular Medicine, Cooper University Health Care/Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ayman Hussein
- Division of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Justin Z Lee
- Division of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
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Knops RE, Ganz L, Nevo JR. A Dual-Chamber Leadless Pacemaker. Reply. N Engl J Med 2023; 389:1056-1057. [PMID: 37703567 DOI: 10.1056/nejmc2308513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Reinoud E Knops
- Amsterdam University Medical Center, Amsterdam, the Netherlands
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10
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Narducci ML, Volpe M. The revolution of beat-to-beat wireless bidirectional communication between intra-cardiac devices. Eur Heart J 2023; 44:3215-3216. [PMID: 37525532 DOI: 10.1093/eurheartj/ehad457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Affiliation(s)
- Maria Lucia Narducci
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, Rome 00168, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome and IRCCS San Raffaele Roma, Via di Grottarossa 1035, Rome 00189, Italy
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11
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Knops RE, Reddy VY, Ip JE, Doshi R, Exner DV, Defaye P, Canby R, Bongiorni MG, Shoda M, Hindricks G, Neužil P, Rashtian M, Breeman KTN, Nevo JR, Ganz L, Hubbard C, Cantillon DJ. A Dual-Chamber Leadless Pacemaker. N Engl J Med 2023; 388:2360-2370. [PMID: 37212442 DOI: 10.1056/nejmoa2300080] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Single-chamber ventricular leadless pacemakers do not support atrial pacing or consistent atrioventricular synchrony. A dual-chamber leadless pacemaker system consisting of two devices implanted percutaneously, one in the right atrium and one in the right ventricle, would make leadless pacemaker therapy a treatment option for a wider range of indications. METHODS We conducted a prospective, multicenter, single-group study to evaluate the safety and performance of a dual-chamber leadless pacemaker system. Patients with a conventional indication for dual-chamber pacing were eligible for participation. The primary safety end point was freedom from complications (i.e., device- or procedure-related serious adverse events) at 90 days. The first primary performance end point was a combination of adequate atrial capture threshold and sensing amplitude at 3 months. The second primary performance end point was at least 70% atrioventricular synchrony at 3 months while the patient was sitting. RESULTS Among the 300 patients enrolled, 190 (63.3%) had sinus-node dysfunction and 100 (33.3%) had atrioventricular block as the primary pacing indication. The implantation procedure was successful (i.e., two functioning leadless pacemakers were implanted and had established implant-to-implant communication) in 295 patients (98.3%). A total of 35 device- or procedure-related serious adverse events occurred in 29 patients. The primary safety end point was met in 271 patients (90.3%; 95% confidence interval [CI], 87.0 to 93.7), which exceeded the performance goal of 78% (P<0.001). The first primary performance end point was met in 90.2% of the patients (95% CI, 86.8 to 93.6), which exceeded the performance goal of 82.5% (P<0.001). The mean (±SD) atrial capture threshold was 0.82±0.70 V, and the mean P-wave amplitude was 3.58±1.88 mV. Of the 21 patients (7%) with a P-wave amplitude of less than 1.0 mV, none required device revision for inadequate sensing. At least 70% atrioventricular synchrony was achieved in 97.3% of the patients (95% CI, 95.4 to 99.3), which exceeded the performance goal of 83% (P<0.001). CONCLUSIONS The dual-chamber leadless pacemaker system met the primary safety end point and provided atrial pacing and reliable atrioventricular synchrony for 3 months after implantation. (Funded by Abbott Medical; Aveir DR i2i ClinicalTrials.gov number, NCT05252702.).
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Affiliation(s)
- Reinoud E Knops
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Vivek Y Reddy
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - James E Ip
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Rahul Doshi
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Derek V Exner
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Pascal Defaye
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Robert Canby
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Maria Grazia Bongiorni
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Morio Shoda
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Gerhard Hindricks
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Petr Neužil
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Mayer Rashtian
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Karel T N Breeman
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Jordan R Nevo
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Leonard Ganz
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Chris Hubbard
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
| | - Daniel J Cantillon
- From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.)
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John RM, De Larochelliere H. Leadless Pacemakers: The Leap from Single to Dual Chamber Pacing. Heart Rhythm 2023:S1547-5271(23)02214-2. [PMID: 37149205 DOI: 10.1016/j.hrthm.2023.04.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Roy M John
- Department of Medicine, Dvision of Cardiology, Stanford University, Palo Alto, CA.
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Reddy VY, Neuzil P, Booth DF, Knops RE, Doshi RN, Rashtian M, Exner DV, Banker RS, Nair D, Hadadi CA, Badie N, Yang W, Ligon D, Ip JE. Dual-Chamber Leadless Pacing: Atrioventricular Synchrony in Preclinical Models of Normal or Blocked Atrioventricular Conduction. Heart Rhythm 2023:S1547-5271(23)02104-5. [PMID: 37075958 DOI: 10.1016/j.hrthm.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/29/2023] [Accepted: 04/09/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Dual-chamber leadless pacemakers (LP) require robust communication between distinct right atrial (RA) and right ventricular (RV) LPs to achieve atrioventricular (AV) synchrony. OBJECTIVE This preclinical study evaluated a novel, continuous implant-to-implant (i2i™) communication methodology for maintaining AV-synchronous, dual-chamber DDD(R) pacing by the 2 LPs. METHODS RA and RV LPs were implanted and paired in 7 ovine subjects, 4 of 7 with induced complete heart block. AV synchrony (% AV intervals <300 ms) and i2i communication success (% successful i2i transmissions between LPs) were evaluated acutely and chronically. During acute testing, 12-lead ECG and LP diagnostic data were collected from 5-minute recordings, in 4 postures and 2 rhythms (AP-VP and AS-VP or AP-VS and AS-VS) per subject. Chronic i2i performance was evaluated through 23 weeks post-implant (final i2i evaluation period: week 16-23). RESULTS Acute AV synchrony and i2i communication success across multiple postures and rhythms were 100.0% [100.0-100.0] (median [interquartile range]) and 99.9% [99.9-99.9], respectively. AV synchrony and i2i success rates did not differ across postures (P=0.59, P=0.11) or rhythms (P=1.00, P=0.82). During the final i2i evaluation period, the overall i2i success was 98.9% [98.1-99.0]. CONCLUSION Successful AV-synchronous, dual-chamber DDD(R) leadless pacing using a novel, continuous, wireless communication modality was demonstrated across variations in posture and rhythm in a preclinical model.
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Affiliation(s)
- Vivek Y Reddy
- Icahn School of Medicine at Mount Sinai, New York, New York, USA; Na Homolce Hospital, Prague, Czech Republic.
| | | | | | | | - Rahul N Doshi
- HonorHealth Research Institute, Scottsdale, Arizona, USA
| | | | - Derek V Exner
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | | | - Devi Nair
- St. Bernard's Heart and Vascular Center, Jonesboro, Arkansas, USA
| | | | | | | | | | - James E Ip
- Weill Cornell Medical Center, New York, New York, USA
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Tong F, Sun Z. Strategies for Safe Implantation and Effective Performance of Single-Chamber and Dual-Chamber Leadless Pacemakers. J Clin Med 2023; 12:jcm12072454. [PMID: 37048538 PMCID: PMC10094832 DOI: 10.3390/jcm12072454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 04/14/2023] Open
Abstract
Leadless pacemakers (LPMs) have emerged as an alternative to conventional transvenous pacemakers to eliminate the complications associated with leads and subcutaneous pockets. However, LPMs still present with complications, such as cardiac perforation, dislodgment, vascular complications, infection, and tricuspid valve regurgitation. Furthermore, the efficacy of the leadless VDD LPMs is influenced by the unachievable 100% atrioventricular synchrony. In this article, we review the available data on the strategy selection, including appropriate patient selection, procedure techniques, device design, and post-implant programming, to minimize the complication rate and maximize the efficacy, and we summarize the clinical settings in which a choice must be made between VVI LPMs, VDD LPMs, or conventional transvenous pacemakers. In addition, we provide an outlook for the technology for the realization of true dual-chamber leadless and battery-less pacemakers.
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Affiliation(s)
- Fei Tong
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Zhijun Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
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Laczay B, Aguilera J, Cantillon DJ. Leadless cardiac ventricular pacing using helix fixation: Step-by-step guide to implantation. J Cardiovasc Electrophysiol 2023; 34:748-759. [PMID: 36542756 DOI: 10.1111/jce.15785] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Leadless cardiac pacemakers are an alternative modality to traditional transvenous pacemaker systems. Recently receiving Food and Drug Administration approval, the AVEIR VR leadless pacemaker system provides a helix based active fixation leadless pacemaker system. This step-by-step review will cover patient selection, preprocedural planning, device implantation technique, implant site evaluation, troubleshooting, short- and long-term complications as well as future directions for leadless pacing. METHODS We collected and reviewed cases from primary operators to provide a step-by-step review for implanters. RESULTS Our paper provides a guide to patient selection, pre-procedural planning, device im plantation technique, implant site evaluation, troubleshooting, short- and long-term complications as well as future directions for leadless pacing. CONCLUSION The helix based active fixation leadless pacemaker system is a safe and efficacious way to provide pacing support to patients and provides an alternative to transvenous pacing systems. Our review provides a step-by-step guide to implantation.
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Affiliation(s)
- Balint Laczay
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Jose Aguilera
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Daniel J Cantillon
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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16
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Clinical Updates in Cardiac Pacing—The Future Is Bright. J Clin Med 2022; 11:jcm11216376. [DOI: 10.3390/jcm11216376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
The history of cardiac pacing has been defined by many innovation milestones starting in the early 1960s [...]
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