Journal
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
Volume 15, Issue 7, Pages 456-463Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCEP.122.010909
Keywords
communication; complications; feasibility study; pacemaker; artificial; sheep
Categories
Funding
- Abbott
- Czech Republic Ministry of Health scientific grant [MH CZ -DRO 00023884, IG160501]
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This preclinical study demonstrates the chronic performance of implant-to-implant communication that achieves synchronous, dual-chamber pacing with 2 leadless pacemakers, achieving a success rate of 99.2%.
Background: Leadless pacemakers (LPs) can mitigate conventional pacemaker complications related to the transvenous leads and subcutaneous pocket surrounding the pulse generator. Although single-chamber leadless pacing has been established, multichamber pacing requires wireless bidirectional communication across multiple LPs to maintain synchrony. This preclinical study demonstrates the chronic performance of implant-to-implant (i2i) communication that achieves synchronous, dual-chamber pacing with 2 LPs. Methods: The i2i communication modality employs subthreshold electrical signals conducted between implanted LPs through the blood and myocardial tissue on a beat-by-beat basis. Right atrial and right ventricular LPs were implanted in 9 ovine subjects. The i2i transmission performance was evaluated 13 weeks after implant. Results: Right atrial and right ventricular LPs were implanted successfully and without complication in 9 ovine subjects. A total of 8715 +/- 457 right atrial-to-right ventricular and right ventricular-to-right atrial transmissions were sent per hour, with a success rate of 99.2 +/- 0.9%. Of periods with i2i communication failure when DDD pacing was not possible, 97.3 +/- 1.8% were resolved within 6 s. Conclusions: For the first time, synchronized, dual-chamber pacing has been demonstrated in a chronic preclinical feasibility study by 2 leadless pacemakers using beat-to-beat, wireless communication, achieving a success rate of 99.2%.
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