Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China.
Division of Cardiology, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen, China.
Pacing Clin Electrophysiol. 2020 Dec;43(12):1438-1450. doi: 10.1111/pace.14105. Epub 2020 Nov 8.
Leadless pacing is a major breakthrough in the management of bradyarrhythmia. Results of initial clinical trials that have demonstrated a significant reduction in acute and long-term pacing-related complications have been confirmed by real-world experience in a broader spectrum of patients. Nonetheless current use of a leadless pacemaker is hampered by its limited atrial sensing and pacing capability, as well as battery life-span and retrievability. We review the current clinical outcome data, indications and contraindications, implantation and retrieval techniques, synchronous ventricular pacing, and other clinical considerations. We also provide an overview of the latest advancements in leadless pacing technology including device-to-device communication and energy harvesting technology.
无导线起搏是治疗缓慢性心律失常的重大突破。最初的临床试验结果证实了这一点,这些临床试验显示急性和长期与起搏相关的并发症显著减少,而更广泛的患者的真实世界经验也证实了这一点。尽管如此,无导线起搏器的当前使用受到其有限的心房感知和起搏能力、电池寿命和可回收性的限制。我们回顾了当前的临床结果数据、适应证和禁忌证、植入和取出技术、同步心室起搏以及其他临床注意事项。我们还概述了无导线起搏技术的最新进展,包括设备到设备的通信和能量采集技术。