3.8 Article

End-of-life Management of Leadless Cardiac Pacemaker Therapy

期刊

ARRHYTHMIA & ELECTROPHYSIOLOGY REVIEW
卷 6, 期 3, 页码 129-133

出版社

RADCLIFFE CARDIOLOGY
DOI: 10.15420/aer.2017:16:1

关键词

Leadless pacemaker therapy; retrieval; end-of-life management; Micra Transcatheter Pacing System; Nanostim Leadless Cardiac Pacemaker; transvenous pacemaker

资金

  1. Boston Scientific
  2. Abbott
  3. Medtronic

向作者/读者索取更多资源

The clinically available leadless pacemakers for patients with a single-chamber pacing indication have shown to be safe and effective. However, the optimal end-of-life strategy of this novel technique is undefined. Suggested strategies comprise of (a) placing an additional leadless device adjacent to the leadless pacemaker, or (b) retrieving the non-functioning leadless pacemaker and subsequently implanting a new device. Although initial studies demonstrate promising results, early experience of acute and mid-term retrieval feasibility and safety remains mixed. We suggest that the approach of leadless pacemaker retrieval is more appealing to limit the amount of non-functioning intracardiac hardware. In addition, potential risks for device-device interference, and unknown long-term complications associated with multiple intracardiac devices are prevented. The potential inability to retrieve chronically implanted leadless pacemakers limits the application of this novel technology. Therefore, long-term prospective analysis is required to define the most optimal end-of-life strategy.

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