Key result
Leadless pacemakers require careful patient selection, procedural techniques, and post-implant programming to minimize complications and maximize efficacy compared to transvenous pacemakers.
Why the study?
Leadless pacemakers eliminate transvenous lead and pocket complications but still present complications, and leadless VDD pacemakers do not achieve 100% atrioventricular synchrony.
What are the optimal strategies for patient selection, implantation, and programming to maximize efficacy and minimize complications of leadless pacemakers?
What are the optimal strategies for patient selection, implantation, and programming to maximize efficacy and minimize complications of leadless pacemakers?
This review provides a comprehensive overview of strategies to minimize complications and maximize efficacy when implanting single- and dual-chamber leadless pacemakers.
Highlights strategies to optimize leadless pacemaker use; hypothesis-generating pending randomized comparisons with transvenous systems.
Leadless pacemakers (LPMs) have emerged as an alternative to conventional transvenous pacemakers to eliminate the complications associated with leads and subcutaneous pockets. However, LPMs still present with complications, such as cardiac perforation, dislodgment, vascular complications, infection, and tricuspid valve regurgitation. Furthermore, the efficacy of the leadless VDD LPMs is influenced by the unachievable 100% atrioventricular synchrony. In this article, we review the available data on the strategy selection, including appropriate patient selection, procedure techniques, device design, and post-implant programming, to minimize the complication rate and maximize the efficacy, and we summarize the clinical settings in which a choice must be made between VVI LPMs, VDD LPMs, or conventional transvenous pacemakers. In addition, we provide an outlook for the technology for the realization of true dual-chamber leadless and battery-less pacemakers.
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Fei Tong (2023) reported a review. Leadless pacemakers vs. Conventional transvenous pacemakers was evaluated. Leadless pacemakers require careful patient selection, procedural techniques, and post-implant programming to minimize complications and maximize efficacy compared to transvenous pacemakers.
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