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Leadless cardiac pacemaker

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 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
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
Haseeb Munaf Seriwala, Muhammad Shahzeb Khan, Muhammad Bilal Munir, Irbaz Bin Riaz, Haris Riaz, Samir Saba, Andrew H Voigt
Cardiac pacemakers are a critical management option for patients with rhythm disorders. Current efforts to develop leadless pacemakers have two primary goals: to reduce lead-associated post-procedural morbidity and to avoid the surgical scar associated with placement. After extensive studies on animal models and technological advancements, these devices are currently under investigation for human use. Herein, we review the evidence from animal studies and the technological advancements that have ushered in the era of use in humans...
January 2016: Journal of Cardiology
Jean-Claude Daubert, Albin Behaghel, Christophe Leclercq, Philippe Mabo
Major improvements in implantable electrical cardiac devices have been made during the last two decades, notably with the advent of automatic internal defibrillation (ICD) to prevent sudden arrhythmic death, and cardiac resynchronisation (CRT) to treat the discoordinated failing heart. They now constitute a major therapeutic option and may eventually supersede drug therapy. The coming era will be marked by a technological revolution, with improvements in treatment delivery, safety and efficacy, and an expansion of clinical indications...
March 2014: Bulletin de L'Académie Nationale de Médecine
Petr Neuzil
No abstract text is available yet for this article.
November 2015: Current Cardiology Reports
Marc A Miller, Petr Neuzil, Srinivas R Dukkipati, Vivek Y Reddy
Despite significant advances in battery longevity, lead performance, and programming features since the first implanted permanent pacemaker was developed, the basic design of cardiac pacemakers has remained relatively unchanged over the past 50 years. Because of inherent limitations in their design, conventional (transvenous) pacemakers are prone to multiple potential short- and long-term complications. Accordingly, there has been intense interest in a system able to provide the symptomatic and potentially lifesaving therapies of cardiac pacemakers while mitigating many of the risks associated with their weakest link-the transvenous lead...
September 8, 2015: Journal of the American College of Cardiology
Vivek Y Reddy, Derek V Exner, Daniel J Cantillon, Rahul Doshi, T Jared Bunch, Gery F Tomassoni, Paul A Friedman, N A Mark Estes, John Ip, Imran Niazi, Kenneth Plunkitt, Rajesh Banker, James Porterfield, James E Ip, Srinivas R Dukkipati
BACKGROUND: Cardiac pacemakers are limited by device-related complications, notably infection and problems related to pacemaker leads. We studied a miniaturized, fully self-contained leadless pacemaker that is nonsurgically implanted in the right ventricle with the use of a catheter. METHODS: In this multicenter study, we implanted an active-fixation leadless cardiac pacemaker in patients who required permanent single-chamber ventricular pacing. The primary efficacy end point was both an acceptable pacing threshold (≤2...
September 17, 2015: New England Journal of Medicine
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