Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Oct;17(10):1508-13.
doi: 10.1093/europace/euv096. Epub 2015 May 29.

State of the art of leadless pacing

Johannes Sperzel  1 , Haran Burri  2 , Daniel Gras  3 , Fleur V Y Tjong  4 , Reinoud E Knops  4 , Gerhard Hindricks  5 , Clemens Steinwender  6 , Pascal Defaye  7
Affiliations
Review

State of the art of leadless pacing

Johannes Sperzel et al. Europace. 2015 Oct.

Abstract

Despite undisputable benefits, conventional pacemaker therapy is associated with specific complications related to the subcutaneous device and the transvenous leads. Recently, two miniaturized leadless pacemakers, Nanostim™ (St. Jude Medical) and Micra™ (Medtronic), which can be completely implanted inside the right ventricle using steerable delivery systems, entered clinical application. The WiCS™-cardiac resynchronisation therapy (CRT) system (wireless cardiac stimulation for CRT, EBR Systems) delivers leadless left ventricular endocardial stimulation for cardiac resynchronization. In addition to obvious cosmetic benefits, leadless pacing systems may have the potential to overcome some complications of conventional pacing. However, acute and long-term complications still remains to be determined, as well as the feasibility of device explantation years after device placement.

Keywords: Catheter delivery; Leadless pacing; Pacemaker.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The St. Jude Medical Nanostim™ leadless pacemaker (reproduced with permission from St. Jude Medical Inc.).
Figure 2
Figure 2
The Medtronic Micra™ Transcatheter Pacing System (reproduced with permission from Medtronic Inc.).
Figure 3
Figure 3
Leadless cardiac pacemaker implantation steps. (A) A venogram may optionally be performed; (B) The LCP is positioned into the RV by deflecting the catheter and placed ∼0.5–1 cm from the RV apex; (C and D) Protective cover is pulled back to expose the flexible part of the catheter; (E) The pacemaker is undocked from the delivery catheter while a tethered connection is maintained. In case the position is suboptimal, the LCP can be reengaged, unscrewed, and repositioned. (F) The LCP is released by rotating the release knob of the catheter.
See this image and copyright information in PMC

Comment in

References

    1. Kirkfeldt RE, Johansen JB, Nohr EA, Jørgensen OD, Nielsen JC. Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark. Eur Heart J 2014;35:1186–94. - PMC - PubMed
    1. Spickler JW, Rasor NS, Kezdi P, Misra SN, Robins KE, LeBoeuf C. Totally self-contained intracardiac pacemaker. J Electrocardiol 1970;3:325–31. - PubMed
    1. Vardas PE, Politopoulos E, Manios E, Parthenakis F, Tsagarakis C. A miniature pacemaker introduced intravenously and implanted endocardially. Preliminary findings form an experimental study. Eur J CPE 1991;1:27–30.
    1. Chauveau S, Brink PR, Cohen IS. Stem cell-based biological pacemakers from proof of principle to therapy: a review. Cytotherapy 2014;16:873–80. - PMC - PubMed
    1. Echt DS, Cowan MW, Riley RE, Brisken AF. Feasibility and safety of a novel technology for pacing without leads. Heart Rhythm 2006;3:1202–6. - PubMed

Publication types

MeSH terms