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Leadless pacing

Sergio Richter, Michael Döring, Micaela Ebert, Kerstin Bode, Andreas Müssigbrodt, Philipp Sommer, Daniela Husser, Gerhard Hindricks
Leadless cardiac pacemaker (LCP) therapy has been established clinically as a feasible and safe alternative to conventional transvenous pacemaker therapy for patients with an indication for single-chamber right-ventricular pacing.1-3 However, reports on loss of telemetry and pacing output due to abrupt battery failure called the safety of one of the two commercially available systems seriously into question. The initial battery advisory with the Nanostim™ LCP was issued by the manufacturer in October 2016, who instantly called a global stop to Nanostim™ implants...
March 14, 2018: Circulation
Shai Tejman-Yarden, Eyal Nof, Roy Beinart, Nadav Ovadia, Yuval Goldshmit, Jonathan Buber, Hagith Yonath, Eitan Keizman, Michael Glikson
Permanent cardiac pacing is the only effective solution for patients with symptomatic bradycardia and heart block. About 10% of patients undergoing implantation of the conventional pacing system develop complications related to the subcutaneous pocket or the leads and in pediatric patients lead problems may rise in up to 30% of the patients. The leadless pacemaker devices were developed in order to minimize some of those complications. We present a case of an 11-year-old patient who presented after the sudden death of his older brother, with recurrent episodes of syncope and documented prolonged sinus pauses...
March 8, 2018: Pediatric Cardiology
Bharath Yarlagadda, Mohit K Turagam, Tawseef Dar, Pragna Jangam, Vaishnavi Veerapaneni, Donita Atkins, Sudharani Bommana, Paul Friedman, Abhishek J Deshmukh, Rahul Doshi, Vivek Y Reddy, Srinivas R Dukkipati, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: Atrioventricular node (AV) ablation and permanent pacing is an established strategy for rate control in the management of symptomatic atrial fibrillation (AF). Leadless pacemakers (LP) can overcome some of the short-term and long-term limitations of conventional transvenous pacemakers (CTP). OBJECTIVES: Compare the feasibility and safety of LP vs single chamber CTP in AF patients undergoing AVN ablation. METHODS: We conducted a multicenter, observational study of patients undergoing AVN ablation and pacemaker implantation (LP vs...
February 26, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Toshimasa Okabe, Mikhael F El-Chami, Michael S Lloyd, Benjamin Buck, Charles C Gornick, JoEllyn C Moore, Ralph S Augostini, John D Hummel
BACKGROUND: Atrioventricular junctional (AVJ) ablation and pacemaker implantation is indicated when pharmacotherapy fails to achieve adequate rate control in atrial fibrillation (AF). The purpose of our study is to assess the feasibility and safety of concurrent Micra leadless transcatheter pacemaker implantation and AVJ ablation. METHODS: We retrospectively assessed patients who underwent Micra implantation and concurrent AVJ ablation at three institutions between 8/2014 and 3/2016...
February 24, 2018: Pacing and Clinical Electrophysiology: PACE
Sofian Johar, Nazar Luqman
A left atrial appendage occluder device (Watchman) and leadless pacemaker (Micra) was implanted from a single right femoral vein access in a 73-year-old female patient with persistent atrial fibrillation and symptomatic tachy-brady syndrome and unable to take oral anticoagulants. Standard methods of implantation were followed for both procedures. The Watchman device was implanted first followed by dilatation of the same venous access site in order to implant Micra transcatheter pacing system. The patient tolerated the procedures well and there were no complications...
February 16, 2018: BMJ Case Reports
Domenico G Della Rocca, Carola Gianni, Luigi Di Biase, Andrea Natale, Amin Al-Ahmad
Leadless pacemaker therapy is a new technology that aims at avoiding lead- and pocket-related complications of conventional transvenous and epicardial pacing. To date, 2 self-contained leadless pacemakers for right ventricular pacing have been clinically available: the Nanostim Leadless Pacemaker System and the Micra Transcatheter Pacing System. Additionally, a new multicomponent leadless pacemaker for endocardial left ventricular pacing has been proposed as an alternative choice for cardiac resynchronization therapy...
March 2018: Cardiac Electrophysiology Clinics
Muhammad R Afzal, Emile G Daoud, Ryan Cunnane, Shiva K Mulpuru, Alan Koay, Azlan Hussain, Razali Omar, Koh Kok Wei, Anish Amin, Gregory Kidwell, Nirav Patel, Charles Love, Michel Llyod, Maciej Sterliński, Seth Goldbarg, Miguel A Leal, James Gabriels, Apoor Patel, Ram Jadonath, Eric Grubman, George Crossley, Chris Pepper, Dhanunjaya Lakkireddy, Toshimasa Okabe, John D Hummel, Ralph S Augostini
BACKGROUND: Due to relatively newer technology, experience with retrieval of Micra transcatheter pacing system (TPS) is limited. Although, it is recommended to abandon the TPS at end of life, certain situations such as endovascular infections or device embolization warrant retrieval. OBJECTIVES: To report worldwide experience of successful retrieval for Micra TPS. METHODS: The list of all successful retrievals for the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS...
February 7, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Niek E G Beurskens, Fleur V Y Tjong, Anne-Floor B E Quast, Reinoud E Knops
No abstract text is available yet for this article.
January 15, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Valentina De Regibus, Darragh Moran, Gian Battista Chierchia, Pedro Brugada, Carlo de Asmundis
Vasovagal syncope is characterized by vasodilatation and/or bradycardia and thereby a fall in arterial BP and global cerebral perfusion in response to a trigger. Although it is a benign condition, patients with frequent and traumatic episodes need treatment in order to improve quality of life. We describe the case of a 17-years-old boy suffering from cardioinhibitory syncope. At the end of a complete negative cardiac and neurological examination, a loop recorder was implanted. During the subsequent follow-up the ILR documented a 9-s pause...
December 21, 2017: Indian Pacing and Electrophysiology Journal
Mohamed Sanhoury, Gaetano Fassini, Fabrizio Tundo, Massimo Moltrasio, Valentina Ribatti, Giuseppe Lumia, Flavia Nicoli, Elisabetta Mancini, Annalisa Filtz, Claudio Tondo
Congenital heart disease patients are considered a unique group of patients regarding their high risk of conduction abnormalities , whether de novo or surgically induced , and the challenges in both implantation and management of device related complications. We present a case of a pacemaker-dependent patient with congenital heart disease who experienced complications of both previous epicardial and transvenous pacing which rendered her a non-suitable candidate of both routes.
February 2017: Journal of Atrial Fibrillation
Krishna Kancharla, Abhishek J Deshmukh, Paul A Friedman
Implantable cardiac pacemakers have seen remarkable progress in the last sixty years and remained as cornerstone therapy for symptomatic bradycardia. Despite this progress the current day traditional transvenous implanted pacemaker systems are limited by the need for a surgically created pocket for the generator, indwelling leads in the vascular system and lastly passage through the tricuspid valve. A majority of the implant and explant related complications are due to the surgical pocket and indwelling leads...
August 2017: Journal of Atrial Fibrillation
Michael S Lloyd, Michael F El-Chami, Kent R Nilsson, Daniel J Cantillon
No abstract text is available yet for this article.
December 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Pascal Defaye, Didier Klug, Frederic Anselme, Daniel Gras, Jean-Sylvain Hermida, Olivier Piot, Christine Alonso, Laurent Fauchier, Estelle Gandjbakhch, Eloi Marijon, Philippe Maury, Jérôme Taieb, Serge Boveda, Nicolas Sadoul
No abstract text is available yet for this article.
January 2018: Archives of Cardiovascular Diseases
Brett Cronin, Michael K Essandoh
With the advent of "wireless" endocardial pacing, the subcutaneous implantable cardioverter defibrillator, and leadless pacemakers comes an added layer of complexity to the perioperative management of cardiovascular implantable electronic devices (CIED). Since no formal recommendations currently exist for these new CIED technologies, preoperative identification of these devices, understanding their functionality, and developing an individualized perioperative management plan are imperative for the anesthesiologist...
September 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Elkin González Villegas, Omar Al Razzo, Jorge Silvestre García, José Mesa García
BACKGROUND: Leadless pacemaker can be considered as a technical revolution in cardiac pacing devices, with clear advantages over conventional pacemakers in overcoming all lead-related complications. However, the management of these devices once they reach the end of life (EOL) of the battery is still controversial. In the next years, there will be an increase in the need to define a clear strategy in the management of leadless PM once they reach their EOL. Safe extraction of these devices will define in a great manner this strategy METHODS: We performed the extraction of three functioning Nanostim leadless pacemaker prophylactically in two females and one male patients as part of the Nanostim battery depletion field action recommendation...
February 2018: Pacing and Clinical Electrophysiology: PACE
Christophe Garweg, Joris Ector, Gabor Voros, Adèle Greyling, Bert Vandenberk, Stefaan Foulon, Rik Willems
AIM: Leadless cardiac pacemaker has been developed to reduce complications related to cardiac pacing and is considered as an alternative to conventional pacemaker although safety and efficacy data in clinical practice are limited. The purpose of this study was to investigate the safety and efficacy profile of Micra Transcatheter Pacing System (TPS) used in daily clinical activity with a focus on challenging cases for conventional pacing. METHODS: A total of 66 patients (46 men, 79...
November 30, 2017: Acta Cardiologica
Eugenio Cingolani, Joshua I Goldhaber, Eduardo Marbán
Electrogenesis in the heart begins in the sinoatrial node and proceeds down the conduction system to originate the heartbeat. Conduction system disorders lead to slow heart rates that are insufficient to support the circulation, necessitating implantation of electronic pacemakers. The typical electronic pacemaker consists of a subcutaneous generator and battery module attached to one or more endocardial leads. New leadless pacemakers can be implanted directly into the right ventricular apex, providing single-chamber pacing without a subcutaneous generator...
March 2018: Nature Reviews. Cardiology
Ngai-Yin Chan, Ho-Chuen Yuen, Ngai-Shing Mok
Leadless cardiac pacemakers (LCP) have become available recently. Both its acute and long-term performance in a large population of patients remain to be tested. Subacute rise in pacing threshold has been reported as an uncommon complication. On the other hand, the retrieval technique for LCP with passive fixation mechanism has not been previously described in details. Herein we report a newly recognized complication of an acute rise in pacing threshold very soon after implantation of an LCP without radiographic dislodgement...
October 28, 2017: Indian Pacing and Electrophysiology Journal
Derek S Chew, Vikas Kuriachan
PURPOSE OF REVIEW: Pacing technology for many decades has been composed of a generator attached to leads that are usually transvenous. Recently, leadless pacemakers have been studied in clinical settings and now available for use in many countries. This includes the single-component Nanostim Leadless Cardiac Pacemaker and Micra Transcatheter Pacing System, as well as the multicomponent Wireless Stimulation Endocardial system. RECENT FINDINGS: Clinical studies in single-component leadless pacing technology has shown that they can be successfully implanted with minimal complications...
January 2018: Current Opinion in Cardiology
Yasushi Oginosawa, Ritsuko Kohno, Hisaharu Ohe, Haruhiko Abe
No abstract text is available yet for this article.
October 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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