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Leadless cardiac pacemaker

Mikhael F El-Chami, Faisal M Merchant, Angel R Leon
Leadless pacing is an emerging technology with the potential to significantly improve outcomes associated with the need for long-term pacing. Specifically, the major advantage of leadless systems is abolishing the need for transvenous leads and subcutaneous pockets, both of which account for most adverse events associated with traditional pacemakers. Two leadless pacemakers are currently available: the Nanostim (leadless cardiac pacemaker [LCP]) device (St. Jude Medical, Sylmar, California) and the Micra Transcatheter pacing system (Medtronic, Minneapolis, Minnesota)...
November 1, 2016: American Journal of Cardiology
Erich L Kiehl, Daniel J Cantillon
Over the last 50 years, the use of transvenous pacemakers has been constrained by long-term complications that affect more than 1 in 10 patients, largely attributable to the endovascular leads and surgical pocket. Leadless cardiac pacing involves a self-contained pacemaker deployed directly into the heart without a lead or incisional access. The procedure has shown promise, eliminating pocket-related complications. Other advantages include postprocedural shoulder mobility and the ability to drive, shower, and bathe...
November 2016: Cleveland Clinic Journal of Medicine
Antoine Da Costa, Amandine Axiotis, Cécile Romeyer-Bouchard, Loucif Abdellaoui, Zahi Afif, Jean Baptiste Guichard, Antoine Gerbay, Karl Isaaz
INTRODUCTION: A lack of information about the feasibility and safety of leadless pacemaker (LPMs) exists in a fragile population of patients with limited venous anatomy access or conventional pacemaker (PM) contraindication. Accordingly, the goal of this prospective observational study was to report our experience with this new leadless technology in a subset of patients with contraindication or limited venous access. METHODS AND RESULTS: Between May 2015 and July 2016, 14 patients were consecutively included...
November 9, 2016: International Journal of Cardiology
Nicodemus Lopes, Diogo Cavaco, Pedro Carmo, Maurício Ibrahim Scanavacca, Pedro Adragão
No abstract text is available yet for this article.
October 2016: Arquivos Brasileiros de Cardiologia
Sana M Al-Khatib, Paul Friedman, Kenneth A Ellenbogen
Advances in the field of defibrillation have brought to practice different types of devices that include the transvenous implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy, the subcutaneous ICD (S-ICD), and the wearable cardioverter-defibrillator. To ensure optimal use of these devices and to achieve best patient outcomes, clinicians need to understand how these devices work, learn the characteristics of patients who qualify them for one type of device versus another, and recognize the remaining gaps in knowledge surrounding these devices...
November 1, 2016: Circulation
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
Yusuke Kondo, Marehiko Ueda, Yoshio Kobayashi, Joerg O Schwab
There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED) over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur...
August 2016: Journal of Arrhythmia
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
Maria Grazia Bongiorni, Giulio Zucchelli, Giovanni Coluccia, Ezio Soldati, Valentina Barletta, Luca Paperini, Francesca Menichetti, Andrea Di Cori, Luca Segreti, Eleonora Del Prete, Roberto Ceravolo
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Kyoko Soejima, Jonathan Edmonson, Michael L Ellingson, Ben Herberg, Craig Wiklund, Jing Zhao
BACKGROUND: Increased magnetic resonance imaging (MRI) adoption and demand are driving the need for device patients to have safe access to MRI. OBJECTIVE: The aim of this study was to address the interactions of MRI with the Micra transcatheter pacemaker system. METHODS: A strategy was developed to evaluate potential MRI risks including device heating, unintended cardiac stimulation, force, torque, vibration, and device malfunction. Assessment of MRI-induced device heating was conducted using a phantom containing gelled saline, and Monte Carlo simulations incorporating these results were conducted to simulate numerous combinations of human body models, position locations in the MRI scanner bore, and a variety of coil designs...
October 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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
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
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 hemodialysis 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...
November 2016: Pacing and Clinical Electrophysiology: PACE
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
Alexander Kypta, Hermann Blessberger, Michael Lichtenauer, Juergen Kammler, Thomas Lambert, Joerg Kellermair, Alexander Nahler, Daniel Kiblboeck, Stefan Schwarz, Clemens Steinwender
BACKGROUND: Leadless cardiac pacemaker (LCP) requires large-caliber venous sheaths for device placement. Sheath sizes for these procedures vary from 18- to 23-French (F). The most common complications are hematomas, pseudoaneurysms, and arteriovenous fistulas. Complete and secure closure of the venous access is an important step at the end of such a procedure. METHODS: We performed a retrospective analysis of all patients who had undergone LCP implantation at our institution...
July 2016: Pacing and Clinical Electrophysiology: PACE
Alexander Kypta, Hermann Blessberger, Juergen Kammler, Michael Lichtenauer, Thomas Lambert, Rene Silye, Clemens Steinwender
No abstract text is available yet for this article.
December 29, 2015: Canadian Journal of Cardiology
Jeffrey Arkles, Joshua Cooper
The role of leadless devices to treat cardiac rhythm disorders and heart failure is emerging. Subcutaneous defibrillator (S-ICD) and leadless pacemakers were developed to ameliorate the risks associated with chronic transvenous leads. Potential benefits of leadless pacemakers and S-ICD include more favorable infection profile, less risk of venous stenosis or occlusion, and less risk of tricuspid valve insufficiency. Novel implantable leadless monitors for heart failure represent a novel diagnostic tool that can guide therapy for CHF...
February 2016: Current Treatment Options in Cardiovascular Medicine
Chu-Pak Lau, Chung-Wah Siu, Kai-Hang Yiu, Kathy Lai-Fun Lee, Yap-Hang Chan, Hung-Fat Tse
Nearly one out of five strokes is associated with atrial fibrillation (AF). Atrial fibrillation is often intermittent and asymptomatic. Detection of AF after cryptogenic stroke will likely change therapy from antiplatelet to oral anticoagulation agents for secondary stroke prevention. A critical step is to convert 'covert' AF into electrocardiogram documented AF. External rhythm recording devices have registered a high incidence of AF to occur after a cryptogenic stroke, but are limited by short duration of continuous recordings...
October 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Keping Chen, Xiaolin Zheng, Yan Dai, Hao Wang, Yue Tang, Tingyu Lan, Jinping Zhang, Yi Tian, Baojie Zhang, Xiaohong Zhou, Matthew Bonner, Shu Zhang
AIMS: The miniaturized leadless pacemaker has recently emerged as a bradycardia therapy in humans, and many patients may need at least two pacemakers in their lifetime. Thus, the present study assessed the effect of two leadless pacemakers in the right ventricle (RV) on cardiac function in a swine model. METHODS AND RESULTS: Fourteen mini pigs were chronically studied. Each animal received two sequential leadless pacemakers in the RV with 1 month between two separate implantations...
January 31, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Alexander Kypta, Hermann Blessberger, Michael Lichtenauer, Clemens Steinwender
No abstract text is available yet for this article.
January 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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