Ten Years of Leadless Cardiac Pacing.

Leadless pacemakers (LPs) are self-contained pacemakers implanted inside the heart, providing a clinical strategy of pacing without pacemaker leads or a subcutaneous pocket. From an experimental therapy first used clinically in 2012, a decade later this technology is an established treatment option. Because of technologic advances and growing evidence, LPs are increasingly being used. Herein, the experience gained from a decade of leadless pacing is reviewed. We cover the safety and efficacy of single-chamber LPs, including comparisons with transvenous pacemakers and various models, and the initial clinical results of the first dual-chamber LP system. Furthermore, evidence and considerations regarding the optimal replacement strategy will be covered. Finally, we discuss future device developments that may broaden indications, such as LPs communicating with subcutaneous implantable cardiac defibrillators and energy-harvesting LPs.
Competing Interests: Funding Support and Author Disclosures Dr Breeman has received an unrestricted research grant from Medtronic. Dr Tjong has received consulting honoraria and research funding from Abbott and Boston Scientific, paid to her institution (no personal financial gain); and is supported by the Dutch Research Council (NWO Rubicon grant no. 452019308), Amsterdam Cardiovascular Sciences, and Health Holland. Dr Miller has served as a consultant for Medtronic and Boston Scientific. Dr Neuzil has received consulting honoraria and research grants from Abbott, Boston Scientific and Medtronic. Dr Dukkipati is a consultant for Biosense Webster; has equity in Manual Surgical Sciences; has received payments from Boston Scientific for the Farapulse acquisition. Dr Knops has received consulting honoraria from Abbott, Boston Scientific, Medtronic, and Cairdac; and has stock options from AtaCor Medical. Dr Reddy is a consultant to Abbott, Boston Scientific, Cairdac, and Medtronic; and has served as a consultant for and has equity in Ablacon, Acutus Medical, Affera-Medtronic, Anumana, Apama Medical-Boston Scientific, APN Health, Append Medical, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, Cardiofocus, CardioNXT/AFTx, Circa Scientific, CoRISMA, Corvia Medical, Dinova-Hangzhou DiNovA EP Technology, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics–Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, Laminar Medical, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, and Valcare, unrelated to this paper; has served as a consultant for Adagio Medical, AtriAN, Biosense-Webster, BioTel Heart, Biotronik, Cardionomic, CoreMap, Fire1, Gore and Associates, Impulse Dynamics, Novartis, Novo Nordisk, Philips, and Pulse Biosciences, unrelated to this paper; and has equity in DRS Vascular, Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed, unrelated to this paper.
(Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)