Chew Derek S, Kuriachan Vikas
Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Curr Opin Cardiol. 2018 Jan;33(1):7-13. doi: 10.1097/HCO.0000000000000468.
Pacing technology for many decades has been composed of a generator attached to leads that are usually transvenous. Recently, leadless pacemakers have been studied in clinical settings and now available for use in many countries. This includes the single-component Nanostim Leadless Cardiac Pacemaker and Micra Transcatheter Pacing System, as well as the multicomponent Wireless Stimulation Endocardial system.
Clinical studies in single-component leadless pacing technology has shown that they can be successfully implanted with minimal complications. The follow-up studies also seem to confirm the findings from the initial clinical trials. These systems offer some advantages over a traditional pacing system comprised of a subcutaneous generator and transvenous leads.
In many ways, these leadless systems are disruptive technologies that are changing the traditional pacemaker concept and preferred for some patients. Ongoing research is needed to better assess their long-term function, safety, and end-of-life strategies. In the future, multichamber leadless pacing is expected to be developed and perhaps obviating the need for transvenous leads and their associated complications.
数十年来，起搏技术一直由连接通常经静脉导线的发生器组成。最近，无导线起搏器已在临床环境中进行研究，现在在许多国家都可供使用。这包括单组件Nanostim无导线心脏起搏器和Micra经导管起搏系统，以及多组件无线刺激心内膜系统。
单组件无导线起搏技术的临床研究表明，它们可以成功植入，并发症极少。随访研究似乎也证实了最初临床试验的结果。这些系统比由皮下发生器和经静脉导线组成的传统起搏系统具有一些优势。
在许多方面，这些无导线系统是颠覆性技术，正在改变传统起搏器概念，并且受到一些患者的青睐。需要进行持续研究以更好地评估其长期功能、安全性和使用寿命结束策略。未来，预计将开发多腔无导线起搏，可能无需经静脉导线及其相关并发症。
