From the Guidelines
Yes, there are new, implanted very small pacemakers, known as leadless pacing systems.
Details of Leadless Pacing Systems
- These systems are a result of technical advances in the field of cardiovascular implantable electronic devices 1.
- The development of leadless pacing systems is aimed at reducing the risk of infection associated with traditional pacemakers 1.
- Although the idea of a biological pacemaker, which could be implanted in the heart, is also being explored, the leadless pacing system is a more immediate reality 1.
- The leadless pacing system is a significant improvement over traditional pacemakers, offering a smaller size and potentially lower risk of complications 1.
From the Research
New Developments in Pacemaker Technology
- Recent advances in miniaturization technologies and battery chemistries have made it possible to develop pacemakers small enough to implant within the heart, providing similar battery longevity to conventional pacemakers 2.
- Leadless pacemakers represent a major leap in technology, emerging as an alternative to traditional systems and promising to eliminate lead and pocket-associated complications 3.
- The Micra Transcatheter Pacing System is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein and implanted directly inside the right ventricle of the heart 2.
Benefits and Limitations of Leadless Pacemakers
- Leadless pacemakers can provide single-chamber pacing without a subcutaneous generator, reducing the risk of complications associated with traditional pacing systems 4.
- However, leadless pacemakers also have limitations, including unknowns related to longevity and end-of-life management for the device 3.
- Despite these limitations, leadless pacemakers have been shown to be effective in reducing the risk of complications, with device-related adverse effects observed in 6.7% of leadless pacemakers compared to 10% of traditional pacemakers with leads 5.
Future Directions in Pacemaker Technology
- Advances in device technology are expected to include alternative energy sources and dual-chamber leadless pacing in the near future 4.
- Biological pacemakers, generated by somatic gene transfer, cell fusion, or cell transplantation, may also provide an alternative to electronic devices, potentially expanding the therapeutic armamentarium for conduction system disorders 4.
- Ongoing research and innovation are aimed at addressing the complications associated with traditional pacemaker systems and improving the safety and efficacy of leadless pacemakers 5.