IMR Press / RCM / Volume 23 / Issue 2 / DOI: 10.31083/j.rcm2302043
Open Access Review
Leadless pacemaker technology: clinical evidence of new paradigm of pacing
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1 Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
*Correspondence: (Maria Lucia Narducci)
Academic Editor: Giacomo Mugnai
Rev. Cardiovasc. Med. 2022, 23(2), 43;
Submitted: 30 November 2021 | Revised: 22 December 2021 | Accepted: 30 December 2021 | Published: 25 January 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Despite continuous technological developments, transvenous pacemakers (PM) are still associated with significant immediate and long-term complications, mostly lead or pocket-related. Recent technological advances brought to the introduction in clinical practice of leadless PM for selected cohort of patients. These miniaturize devices are implanted through the femoral vein and advanced to the right ventricle, without leaving leads in place. Lack of upper extremity vascular access and/or high infective risk in patients requiring VVI pacing are the most common indications to leadless PM. The recently introduced MICRA AV leadless PM also allows ventricular synchronization through mechanical sensing of atrial contraction waves, thus solving the problem of AV synchronization. This review will discuss and summarize available clinical evidence on leadless PM, their performance compared to transvenous devices, current applications and future perspectives.

Leadless pacing
Transvenous pacing
Fig. 1.
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