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Leadless pacing

Arun Gopi
No abstract text is available yet for this article.
March 2016: Indian Pacing and Electrophysiology Journal
Michael L Bernard
BACKGROUND: Worldwide, more than 700,000 pacemakers are implanted annually with more than 250,000 implanted in the United States. Since the first fully transvenous pacemaker implantations in the early 1960s, great technologic advances have been made in pacing systems. However, the combination of subcutaneous pulse generators and transvenous pacing leads has remained constant for more than 50 years. Leadless pacing systems offer an alternative to traditional pacing systems by eliminating the need for permanent transvenous leads while providing therapy for patients with bradyarrhythmias...
2016: Ochsner Journal
Mikhael F El-Chami, Paul R Roberts, Alex Kypta, Pamela Omdahl, Matthew D Bonner, Robert C Kowal, Gabor Z Duray
Two major studies have shown that leadless pacemakers are safe and effective for patients requiring right ventricular rate responsive pacing therapy. This positive result recently led to FDA approval of one of the available leadless pacing devices. While this new technology is promising, it requires a different skill set for safe implantation. In this article, we review in detail the different steps required for implantation of tine-based leadless pacemakers while providing tips and tricks to minimize complications...
September 7, 2016: Journal of Cardiovascular Electrophysiology
Marcus Ståhlberg, Frieder Braunschweig, Fredrik Gadler, Lars Mortensen, Lars H Lund, Cecilia Linde
Heart failure (HF) is considered as an epidemic and affects 2% of the population in the Western world. About 15-30% of patients with HF and reduced ejection fraction (HFrEF) also have prolonged QRS duration on the surface ECG, most commonly as a result of left-bundle branch block (LBBB). Increased QRS duration is a marker of a dyssynchronous activation, and subsequent contraction, pattern in the left ventricle (LV). When dyssynchrony is superimposed on the failing heart it further reduced systolic function and ultimately worsens outcome...
August 30, 2016: Scandinavian Cardiovascular Journal: SCJ
Kim H Chan, Michele McGrady, Ian Wilcox
No abstract text is available yet for this article.
June 30, 2016: New England Journal of Medicine
Dwight W Reynolds, Philippe Ritter
No abstract text is available yet for this article.
June 30, 2016: New England Journal of Medicine
Alban-Elouen Baruteau, Robert H Pass, Jean-Benoit Thambo, Albin Behaghel, Solène Le Pennec, Elodie Perdreau, Nicolas Combes, Leonardo Liberman, Christopher J McLeod
UNLABELLED: Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental passage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive cardiac conduction disorders...
September 2016: European Journal of Pediatrics
Pasi P Karjalainen, Wail Nammas, Tuomas Paana
An 83-year-old lady had a DDDR pacemaker inserted in 1997 for symptomatic atrioventricular block. She underwent battery replacement in 2008. In 2010, she developed atrial fibrillation; the pacemaker was switched to VVIR mode. During the last 2years, ventricular lead threshold increased progressively. In December 2015, she presented for elective battery replacement. After successful battery replacement, the ventricular lead threshold remained high; therefore, we implanted a leadless transcatheter pacemaker, via femoral vein access, using a dedicated catheter delivery system...
July 2016: Journal of Electrocardiology
Alexander Kypta, Hermann Blessberger, Juergen Kammler, Thomas Lambert, Michael Lichtenauer, Walter Brandstaetter, Michael Gabriel, Clemens Steinwender
BACKGROUND: Conventional pacemaker therapy is limited by short- and long-term complications, most notably device infection. Transcatheter pacing systems (TPS) may be beneficial in this kind of patients as they eliminate the need for a device pocket and leads and thus may reduce the risk of re-infection. METHODS: We assessed a novel procedure in 6 patients with severe device infection who were pacemaker dependent. After lead extraction a single chamber TPS was implanted into the right ventricle...
September 2016: Journal of Cardiovascular Electrophysiology
Hans Rutzen-Lopez, Jose Silva, Robert H Helm
Since the initial introduction of pacemakers and defibrillators, the rapid growth in microcircuit and battery technology has increased the longevity demands and exposed the vulnerabilities of transvenous leads. Over a half of century later, leadless pacemaker and defibrillation systems are just reaching the clinical arena. Despite the remarkable advantages of leadless pacing systems, the data are still quite limited and broad implementation of these technologies need to occur in a cautious and deliberate fashion as the peri-procedural risks remains high...
August 2016: Current Treatment Options in Cardiovascular Medicine
Chu-Pak Lau, Kathy Lai-Fun Lee
Entirely leadless cardiac pacemakers that are delivered transvenously required the use of large diameter delivery sheath and femoral venous approach. The complexity of external femoral and iliac venous anatomy may limit their implantation. We describe a patient without subclavian venous access and a conventional pacemaker with a failed right ventricular lead, who had difficult iliac venous anatomy that was also compressed by an external endovascular abdominal aortic stent. Successful leadless pacing using a Micra™ (Medtronic Inc) was accomplished with a strong support wire, hydrophilic delivery sheath and guided by venography...
May 25, 2016: Pacing and Clinical Electrophysiology: PACE
Alexander Kypta, Hermann Blessberger, Michael Lichtenauer, Clemens Steinwender
A 64-year-old patient underwent implantation of a transcatheter pacing systems (TPS) for severe lead endocarditis. The patient experienced fever after a dental procedure. On the transoesophageal echocardiogram (TEE), vegetations were attached to the leads. Because the patient was pacemaker dependent, a temporary pacing lead had to be placed. After removal, however, he did not improve. A second TEE showed new vegetations. Ventricular fibrillation occurred spontaneously; so isoprenalin had to be stopped and a new lead was implanted...
2016: BMJ Case Reports
Menahem Y Rotenberg, Hovav Gabay, Yoram Etzion, Smadar Cohen
A noninvasive, effective approach for immediate and painless heart pacing would have invaluable implications in several clinical scenarios. Here we present a novel strategy that utilizes the well-known mechano-electric feedback of the heart to evoke cardiac pacing, while relying on magnetic microparticles as leadless mechanical stimulators. We demonstrate that after localizing intravenously-injected magnetic microparticles in the right ventricular cavity using an external electromagnet, the application of magnetic pulses generates mechanical stimulation that provokes ventricular overdrive pacing in the rat heart...
2016: Scientific Reports
Christian Meyer, Christiane Jungen, Nils Gosau, Boris Hoffmann, Christian Eickholt, Stephan Willems
Electrical cardiac pacing today is the standard therapy for symptomatic bradycardia. Importantly, despite technical advantages, complications associated with conventional transvenous pacing leads and pockets are still challenging in a relevant number of patients. Beyond cosmetic benefits, miniaturized leadless pacemaker may partly overcome these limitations and beneficially influence implantation-related physical restrictions. Initial findings with single-chamber pacemakers for right ventricular pacing, which are completely implanted via a femoral venous vascular access, are promizing...
April 2016: Deutsche Medizinische Wochenschrift
Volkmar Falk, Christoph T Starck
No abstract text is available yet for this article.
May 2016: Expert Review of Medical Devices
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Cardiovascular Journal of Africa
F V Y Tjong, T F Brouwer, L Smeding, K M Kooiman, J R de Groot, D Ligon, R Sanghera, M J Schalij, A A M Wilde, R E Knops
AIMS: The subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemaker (LP) are evolving technologies that do not require intracardiac leads. However, interactions between these two devices are unexplored. We investigated the feasibility, safety, and performance of combined LP and S-ICD therapy, considering (i) simultaneous device-programmer communication, (ii) S-ICD rhythm discrimination during LP communication and pacing, and (iii) post-shock LP performance. METHODS AND RESULTS: The study consists of two parts...
March 3, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
D G Wilson, J M Morgan, P R Roberts
No abstract text is available yet for this article.
April 15, 2016: International Journal of Cardiology
Hussam Ali, Pierpaolo Lupo, Riccardo Cappato
Although conventional implantable cardioverter-defibrillators (ICDs) have proved effective in the prevention of sudden cardiac death (SCD), they still appear to be limited by non-trivial acute and long-term complications. The recent advent of an entirely subcutaneous ICD (S-ICD) represents a further step in the evolution of defibrillation technology towards a less-invasive approach. This review highlights some historical and current issues concerning the S-ICD that may offer a viable therapeutic option in selected patients at high risk of SCD and in whom pacing is not required...
August 2015: Arrhythmia & Electrophysiology Review
Katrina Mountfort, Reinoud Knops, Johannes Sperzel, Petr Neuzil
Pacemaker technologies have advanced dramatically over the decades since they were first introduced, and every year many thousands of new implants are performed worldwide. However, there continues to be a high incidence of acute and chronic complications, most of which are linked to the lead or the surgical pocket created to hold the device. A leadless pacemaker offers the possibility of bypassing these complications, but requires a catheter-based delivery system and a means of retrieval at the end of the device's life, as well as a way of repositioning to achieve satisfactory pacing thresholds and R waves, a communication system and low peak energy requirements...
May 2014: Arrhythmia & Electrophysiology Review
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