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Leadless pacing

Sondenlose Herzschrittmacher

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Abstract

Leadless self-contained intracardiac pacemakers were developed with the aim of abolishing the short- and long-term risk of lead- and pocket-related complications associated with transvenous devices. Leadless pacemakers promise minimally invasive procedures, long battery lives, and small amounts of foreign materials in the body. Experiences with the pioneering single-chamber devices have provided reasons for optimism about the future of the leadless concept. In the future, as more patients receive and live longer with implantable devices, the total risk of procedure- and lead-related complications is expected to increase, adding a sense of urgency to the need for leadless alternatives to transvenous pacemakers. This review surveys the performance of currently available leadless pacemakers as well as emerging new innovative adaptations and applications of the leadless concept.

Zusammenfassung

Sondenfrei integrierte intrakardiale Schrittmacher wurden mit dem Ziel entwickelt, das kurz- und langfristige Risiko für durch Elektroden und chirurgisch bedingte Komplikationen im Zusammenhang mit konventionellen Systemen zu beseitigen. „Leadless pacer“ versprechen minimalinvasive Eingriffe und einen geringen Anteil an Fremdmaterial im Körper. Erfahrungen mit den wegweisenden Einkammergeräten haben Anlass zu Optimismus für die weitere klinische Anwendung des Leadless-Konzepts gegeben. Da in Zukunft mehr Patienten mit implantierbaren Geräten versorgt werden und länger leben, wird davon ausgegangen, dass das Gesamtrisiko von verfahrens- und sondenbedingten Komplikationen steigt, was die Notwendigkeit dringender Alternativen zu transvenösen Herzschrittmachern erhöht. In der vorliegenden Übersichtsarbeit werden die Erfahrungen mit den derzeitig verfügbaren sondenlosen Herzschrittmachern dargestellt, und es wird ein Überblick über neue, innovative klinische und therapeutische Optionen gegeben.

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Authors and Affiliations

  1. Herzzentrum, Kerckhoff-Klinik GmbH, Bad Nauheim, Germany

    J. Sperzel, C. Hamm & A. Hain

  2. Electrophysiology/Device Therapies, Kerckhoff-Klinik GmbH, Benekestr. 2–8, 61231, Bad Nauheim, Germany

    J. Sperzel

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Correspondence to J. Sperzel.

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J. Sperzel, C. Hamm, and A. Hain declare that they have no competing interests.

The authors did not conduct any studies with human or animal participants for this article. As for other studies cited here, information on ethical guidelines may be found in the respective sources.

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Sperzel, J., Hamm, C. & Hain, A. Leadless pacing. Herz 43, 605–611 (2018). https://doi.org/10.1007/s00059-018-4752-9

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