Leadless Pacemaker Technologies: Patient Selection, Approach, and Outcomes

被引：2

作者：

Koene R.J. ^{[1
]}

Cantillon D.J. ^{[1
]}

机构：

[1] Department of Cardiovascular Medicine, Heart and Vascular Institute, J2-2 Cleveland Clinic, 9500 Euclid Avenue, Cleveland, 44195, OH

来源：

Current Cardiovascular Risk Reports | 2018年 / 12卷 / 4期

关键词：

Leadless pacemakers; Outcomes; Patient selection; Techniques;

D O I：

10.1007/s12170-018-0575-8

中图分类号：

学科分类号：

摘要：

Purpose of Review: Leadless cardiac pacemakers have recently entered clinical use for patients requiring single ventricular chamber pacing only. Two leadless systems have been utilized, the Nanostim leadless cardiac pacemaker and the Micra transcatheter pacing system. While currently limited to only a minority of pacemaker eligible patients, technical hurdles are expected to be overcome which will allow this technology to reach a much broader population. This review discusses the patient population for which these devices are indicated, the approach to device implantation and retrieval, and ongoing data on their long-term use. Recent Findings: Two major non-randomized clinical trials investigating the Nanostim and Micra leadless pacemaker systems were published in the New England Journal of Medicine in 2015 and 2016, respectively, with implant success rates of the active and passive fixation devices of 95.8 and 99.2%, respectively. The Nanostim and Micra demonstrated efficacy and safety, with major complication rates of 6.7 and 4% at 6 months, respectively, comparing favorably to historical transvenous pacemaker controls. Ongoing real-world registry data from Micra shows similar results, whereas Nanostim implantations have been halted due to an unexpected battery malfunction alert in late 2016. More data on device retrieval has become available, along with other strategies for end-of-life management. Summary: Leadless pacemakers have emerged in clinical use based on their clinical outcomes and safety profile. These devices are expected to further revolutionize the field of cardiac pacing. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

引用

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