von Felten Elia, Breitenstein Alexander, Hofer Daniel
Klinik für Kardiologie, Stadtspital Zürich, Triemli, Birmensdorferstrasse 497, 8055, Zürich, Schweiz.
Klinik für Kardiologie, Universitäres Herzzentrum, Universitätsspital Zürich, Zürich, Schweiz.
Herz. 2025 Sep 16. doi: 10.1007/s00059-025-05337-7.
Previous leadless pacemaker systems were confined to the right ventricle, thus limiting the clinical applications. With the introduction of the first leadless atrial cardiac pacemaker, new perspectives in antibradycardia treatment were introduced. This device enables leadless atrial stimulation and electrical atrial sensing with the potential to reduce complications of cardiac pacemaker treatment. The atrial leadless atrial pacemaker is implanted transvenously with a delivery catheter via the femoral vein into the base of the right atrial appendage. In combination with a ventricular leadless pacemaker, a complete dual chamber pacemaker system can be created through galvanically coupled intracorporeal communication. This can be created as an upgrade from an already implanted ventricular or atrial leadless cardiac pacemaker or the system can be implanted directly (de novo). The possibility of an upgrade enables a flexible treatment adapted to the individual progression of the underlying disease. Current limitations for wider clinical use include economic considerations, limited battery capacity and insufficient data concerning retrievability after the battery is exhausted.
先前的无导线起搏器系统局限于右心室，因此限制了临床应用。随着首款无导线心房心脏起搏器的推出，抗心动过缓治疗引入了新的视角。该装置能够进行无导线心房刺激和心房电感知，有可能减少心脏起搏器治疗的并发症。心房无导线起搏器通过输送导管经股静脉经静脉植入右心耳基部。与心室无导线起搏器相结合，可通过电耦合体内通信创建完整的双腔起搏器系统。这既可以作为已植入的心室或心房无导线心脏起搏器的升级来创建，也可以直接（从头开始）植入该系统。升级的可能性使治疗能够灵活地适应基础疾病的个体进展。目前更广泛临床应用的限制包括经济因素、电池容量有限以及电池耗尽后有关可回收性的数据不足。
