IMR Press / RCM / Volume 23 / Issue 3 / DOI: 10.31083/j.rcm2303107
Open Access Review
Bridging the future of cardiac stimulation: physiologic or leadless pacing?
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1 Department of Cardiology, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
2 Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
*Correspondence: (Mauro Biffi)
These authors contributed equally.
Academic Editor: Konstantinos P. Letsas
Rev. Cardiovasc. Med. 2022, 23(3), 107;
Submitted: 30 November 2021 | Revised: 11 January 2022 | Accepted: 26 January 2022 | Published: 17 March 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Cardiac simulation has moved from early life-saving pacemakers meant only to prevent asystole to current devices capable of physiologic stimulation for the treatment of heart rhythm and heart failure, that are also intended for remote patient and disease-progression monitoring. The actual vision of contemporary pacing aims to correct the electrophysiologic roots of mechanical inefficiency regardless of underlying structural heart diseases. The awareness of the residual cardiac dyssynchrony related to customary cardiac pacing has changed the concept of what truly represents “physiologic pacing”. On a different perspective, leadless stimulation to abolish CIED surgery and prevent lead-related complications is becoming a priority both for young device recipients and for frail, elderly patients. Careful clinical evaluation attempts to bridge decision-making to patient-tailored therapy.

cardiac stimulation
conduction system pacing
leadless pacing
heart failure
Fig. 1.
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