Nanostim leadless pacemaker system: A longer waiting period after active fixation may reduce unnecessary repositioning

Kawata, Hiro; Patel, Pranav; Banker, Rajesh

doi:10.1016/j.hrcr.2017.11.003

Cited by 2 publications

(4 citation statements)

References 6 publications

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“…Rather than reposition the system, it was decided to wait for 30 min, at which time the pacing threshold was 2.25 V at 0.4 ms and impedance dropped to 1520 Ω. The same report described another case in which the pacing threshold was >6.5 V and impedance was 1330 Ω, but after allowing 25 min to elapse, the capture threshold decreased to 2.0 V at 0.4 ms and impedance was measured the next day at 800 Ω [9]. In fact, thresholds continued to improve in both cases the day after implant.…”

Section: Implantation Techniquesmentioning

confidence: 99%

“…In fact, thresholds continued to improve in both cases the day after implant. It has been speculated that acute injury caused by the extension of the active-fixation helix being screwed into the myocardium might cause an increase in threshold that attenuates rapidly [9]. Thus, it may not always be necessary to reposition the device during implant in order to obtain adequate thresholds; instead, it requires a perioperative waiting period.…”

Section: Implantation Techniquesmentioning

confidence: 99%

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Leadless Pacemakers

Magnusson¹,

Pergolizzi²,

LeQuang³

2019

Cardiac Pacing and Monitoring - New Methods, Modern Devices

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Leadless or transcatheter pacemakers have recently been introduced to market with important benefits and some limitations. Implanted entirely within the right ventricle, these devices eliminate the need for transvenous pacing leads and pacemaker pockets and thus reduce the risk of infections and lead-related problems. Currently, they offer only VVI/R pacing and they cannot provide atrial sensing, antitachycardia pacing, or AV synchrony. They offer a number of features (such as rate response) and electrogram storage, albeit more limited than in a transvenous system. Real-world clinical data are needed to better comment on projected battery life, which manufacturers suggest will be at least equivalent to transvenous devices. Extracting an implanted leadless pacemaker remains a challenge, although proprietary snare and removal systems are available. However, a leadless pacemaker at end of service may be programmed to OOO and left in place; a revised device may be implanted adjacent. These innovative new devices may have important uses in special populations. Initial data on implant success and adverse events are favorable. Currently, there are two leadless pacemakers available: the Micra™ device by Medtronic and the Nanostim™ device by Abbott (formerly St. Jude Medical).

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Section: Implantation Techniquesmentioning

confidence: 99%

Section: Implantation Techniquesmentioning

confidence: 99%

Leadless Pacemakers

Magnusson¹,

Pergolizzi²,

LeQuang³

2019

Cardiac Pacing and Monitoring - New Methods, Modern Devices

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show abstract

“…To address these lead and device pocketrelated issues, leadless pacemaker systems were recently introduced to prevent post-transplant complications because leadless pacemakers with a catheter delivery do not need sensing and pacing leads, or a pocket on the top of the chest. Currently, two leadless pacing systems are clinically available: the Nanostim Leadless Cardiac Pacemaker from St. Jude Medical, and the Micra Transcatheter Pacing System from Medtronic [4][5]. Both Nanostim and the Micra system provide single chamber sensing and pacing functionality of the right ventricle.…”

Section: Introductionmentioning

confidence: 99%

“…3, the input transconductor Gm2 and feedback transconductor Gm3 convert the input voltage and feedback voltage to the currents. The overall gain of the CFIA is calculated as in (5).…”

Section: Introductionmentioning

confidence: 99%

Current-Reused Current Feedback Instrumentation Amplifier for Low Power Leadless Pacemakers

et al. 2021

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This paper proposes a cardiac electrogram acquisition and stimulation integrated circuit (IC) for single-chamber leadless pacemaker applications. The proposed IC features self-determining pacing by acquiring an intracardiac electrogram without an external digital signal processor (DSP). To achieve both high noise-power efficiency and high input impedance, a novel current-feedback instrumentation amplifier (CFIA) is proposed. In this proposed CFIA, the current-reused cascode differential-difference input stage and class-AB biasing stage are merged. The electrocardiogram (ECG) sensing channel, equipped with a 60-Hz notch filter to relieve powerline interference (PLI), achieves a power supply rejection ratio (PSRR) of 80 dB, a common mode rejection ratio (CMRR) of 174 dB, and an input referred noise of 3.47 μVRMS, in a 350 Hz bandwidth. The ECG acquisition and cardiac pacing functionality of the IC are evaluated in a swine's right ventricle via a 4-electrode catheter.

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Nanostim leadless pacemaker system: A longer waiting period after active fixation may reduce unnecessary repositioning

Cited by 2 publications

References 6 publications

Leadless Pacemakers

Leadless Pacemakers

Current-Reused Current Feedback Instrumentation Amplifier for Low Power Leadless Pacemakers

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