Trohman Richard G
Section of Electrophysiology, Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, 1653 W. Congress, Chicago, IL 60612, USA.
Micromachines (Basel). 2025 Jan 14;16(1):89. doi: 10.3390/mi16010089.
Although significant strides have been made in cardiac pacing, the field is still evolving. While transvenous permanent pacing is highly effective in the management of bradyarrhythmias, it is not risk free and may result in significant morbidity and, rarely, mortality. Transvenous leads are often the weakest link in a pacing system. They may dislodge, fracture, or suffer breaches in their insulation. This review was undertaken to clarify leadless risks, benefits, and alternatives to transvenous cardiac pacing for bradyarrhythmias and heart failure management. In order to clarify the role(s) of leadless pacing, this narrative review was undertaken by searching MEDLINE to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and review articles, as well as other clinically relevant reports and studies. The search was limited to English-language reports published between 1932 and 2024. Leadless pacing was searched using the terms Micra™, Nanostim™, AVEIR™, single-chamber leadless pacemaker, dual-chamber leadless pacemaker, cardiac resynchronization therapy (CRT), cardiac physiological pacing (CPP) and biventricular pacing (BiV). Google and Google Scholar, as well as bibliographies of identified articles were also reviewed for additional references. The advantages and limitations of leadless pacing as well as options that are under investigation are discussed in detail.
尽管心脏起搏技术已取得显著进展，但该领域仍在不断发展。经静脉永久起搏在缓慢性心律失常的治疗中非常有效，但并非没有风险，可能导致严重的发病情况，甚至极少情况下会导致死亡。经静脉导线往往是起搏系统中最薄弱的环节。它们可能会移位、断裂或绝缘层破损。本综述旨在阐明无导线起搏在治疗缓慢性心律失常和心力衰竭方面的风险、益处以及经静脉心脏起搏的替代方案。为了阐明无导线起搏的作用，本叙述性综述通过检索MEDLINE来识别同行评审的临床试验、随机对照试验、荟萃分析和综述文章，以及其他临床相关报告和研究。检索仅限于1932年至2024年发表的英文报告。使用术语Micra™、Nanostim™、AVEIR™、单腔无导线起搏器、双腔无导线起搏器、心脏再同步治疗（CRT）、心脏生理性起搏（CPP）和双心室起搏（BiV）来检索无导线起搏相关内容。还对谷歌和谷歌学术以及已识别文章的参考文献进行了审查以获取更多参考文献。本文详细讨论了无导线起搏的优点和局限性以及正在研究的选项。
