Key result
Leadless pacemakers reduce long-term complications vs transvenous pacemakers while maintaining high implantation success.
Why the study?
Transvenous pacemakers remain associated with significant lead- and pocket-related complications, prompting the introduction of leadless pacemakers into clinical practice.
Does leadless pacemaker technology improve safety and efficacy compared to transvenous pacemakers in patients requiring VVI pacing?
Does leadless pacemaker technology improve safety and efficacy compared to transvenous pacemakers in patients requiring VVI pacing?
Leadless pacemakers offer a safe and effective alternative to transvenous pacemakers, particularly for patients with vascular access issues or high infection risk, with lower long-term complication rates.
May support use in select high-infection-risk patients; leaves open need for randomized confirmation before broader adoption.
Despite continuous technological developments, transvenous pacemakers (PM) are still associated with significant immediate and long-term complications, mostly lead or pocket-related. Recent technological advances brought to the introduction in clinical practice of leadless PM for selected cohort of patients. These miniaturize devices are implanted through the femoral vein and advanced to the right ventricle, without leaving leads in place. Lack of upper extremity vascular access and/or high infective risk in patients requiring VVI pacing are the most common indications to leadless PM. The recently introduced MICRA AV leadless PM also allows ventricular synchronization through mechanical sensing of atrial contraction waves, thus solving the problem of AV synchronization. This review will discuss and summarize available clinical evidence on leadless PM, their performance compared to transvenous devices, current applications and future perspectives.
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Bencardino et al. (2022) conducted a review in Bradyarrhythmias requiring pacing. Leadless pacemakers (Nanostim LCP, Micra TPS) vs. Transvenous pacemakers was evaluated. Leadless pacemakers demonstrate high implantation success rates and a significant reduction in long-term complications compared to traditional transvenous pacemakers.
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