Nadarajah Ramesh, Ali Noman, Patel Peysh A
Department of Cardiology, Leeds Teaching Hospitals NHS Trust, UK.
Department of Cardiology, Leeds Teaching Hospitals NHS Trust, UK.
Indian Heart J. 2019 Nov-Dec;71(6):431-433. doi: 10.1016/j.ihj.2019.11.255. Epub 2019 Nov 19.
Endocardial transvenous permanent pacemakers (TVPs) are a mainstay within cardiology and used to treat a range of bradyarrhythmias. However, their use is associated with potential complications both at the time of implantation and longer term. The concept of a leadless pacemaker, where a self-contained device is placed within the right ventricle, has obvious attractions. Two leadless systems have been developed, though only one is currently available. Results from clinical trials have been promising but a number of hurdles need to be circumvented before leadless devices can usurp TVPs. At present, use is restricted to specialist centres, for a limited indication and for patients in whom conventional implantation is contraindicated. This article provides a contemporary critique of design types, evidence base and existing limitations of this nascent technology.
心内膜经静脉永久起搏器（TVP）是心脏病学的主要治疗手段，用于治疗一系列缓慢性心律失常。然而，其使用在植入时和长期都存在潜在并发症。无导线起搏器的概念，即将一个独立的装置置于右心室内，具有明显的吸引力。目前已开发出两种无导线系统，但仅有一种可供使用。临床试验结果令人鼓舞，但在无导线装置能够取代TVP之前，还需要克服一些障碍。目前，其使用仅限于专科中心，适应证有限，且仅适用于传统植入术禁忌的患者。本文对这项新兴技术的设计类型、证据基础和现有局限性进行了当代评论。
