Pacing devices to treat bradycardia: current status and future perspectives

被引：15

作者：

Biffi, Mauro ^{[1
]}

Capobianco, Claudio ^{[1
,2
]}

Spadotto, Alberto ^{[1
,2
]}

Bartoli, Lorenzo ^{[1
,2
]}

Sorrentino, Sergio ^{[1
,2
]}

Minguzzi, Alessandro ^{[1
,2
]}

Piemontese, Giuseppe Pio ^{[1
,2
]}

Angeletti, Andrea ^{[1
,2
]}

Toniolo, Sebastiano ^{[1
,2
]}

Statuto, Giovanni ^{[1
,2
]}

机构：

[1] Azienda Osped Univ Bologna, Bologna, Italy

[2] Dept Expt Diagnost & Specialty Med, Bologna, Italy

来源：

EXPERT REVIEW OF MEDICAL DEVICES | 2021年 / 18卷 / 02期

关键词：

Atrio-ventricular coupling; clinical outcome; conduction system disease; individualized therapy; leadless Pacemaker; physiologic pacing; CARDIAC RESYNCHRONIZATION THERAPY; 1ST-DEGREE ATRIOVENTRICULAR-BLOCK; ATRIAL-FIBRILLATION; HEART-FAILURE; LONG-TERM; LEADLESS PACEMAKER; CLINICAL-OUTCOMES; RISK-FACTORS; COMPLICATIONS; METAANALYSIS;

D O I：

10.1080/17434440.2021.1866543

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Introduction: Cardiac stimulation evolved from life-saving devices to prevent asystole to the treatment of heart rhythm disorders and heart failure, capable of remote patient and disease-progression monitoring. Cardiac stimulation nowadays aims to correct the electrophysiologic roots of mechanical inefficiency in different structural heart diseases. Areas covered: Clinical experience, as per available literature, has led to awareness of the concealed risks of customary cardiac pacing, that can inadvertently cause atrio-ventricular and inter/intra-ventricular dyssynchrony. New pacing modalities have emerged, leading to a new concept of what truly represents 'physiologic pacing' beyond maintenance of atrio-ventricular coupling. In this article we will analyze the emerging evidence in favor of the available strategies to achieve an individualized physiologic setting in bradycardia pacing, and the hints of future developments. Expert opinion: 'physiologic stimulation' technologies should evolve to enable an effective and widespread adoption. In one way new guiding catheters and the adoption of electrophysiologic guidance and non-fluoroscopic lead implantation are needed to make His-Purkinje pacing successful and effective at long term in a shorter procedure time; in the other way leadless stimulation needs to upgrade to a superior physiologic setting to mimic customary DDD pacing and possibly His-Purkinje pacing.

引用

页码：161 / 177

页数：17

共 103 条

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