Transcatheter leadless cardiac pacing

Costa, Antoine Da; Axiotis, Amandine; Romeyer‐Bouchard, Cécile; Abdellaoui, Loucif; Afif, Zahi; Guichard, Jean-Baptiste; Gerbay, Antoine; Isaaz, Karl

doi:10.1016/j.ijcard.2016.11.196

Cited by 25 publications

(14 citation statements)

References 27 publications

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“…This study highlighted the safety and efficacy of leadless pacemakers in patients with venous abnormalities and kidney failure with limited venous access. 36 In a case series including six patients who underwent Micra™ TPS (Medtronic, Minneapolis, MN, USA) placement, implantation was successful in all patients. As compared with at immediately following implantation, sensing and pacing values were stable at one month and six months after implantation.…”

Section: Available Studies On Efficacy and Safetymentioning

confidence: 93%

“…34 Da Costa et al evaluated the safety, efficacy, and feasibility of Micra™ TPS (Medtronic, Minneapolis, MN, USA) implantation in 14 patients with difficult access or contraindications for conventional pacemaker placement. 36 Implantation was successful in 100% of patients, with a mean procedure time of 45 minutes ± 7 minutes. No direct access site complications, device dislodgements, or cases of embolization were reported.…”

Section: Available Studies On Efficacy and Safetymentioning

confidence: 99%

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Safety and Efficacy of Leadless Pacemakers: A New Era of Pacing

Ammari

Syed

Al-Sarie

et al. 2018

J Innov Cardiac Rhythm Manage.

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Section: Available Studies On Efficacy and Safetymentioning

confidence: 93%

Section: Available Studies On Efficacy and Safetymentioning

confidence: 99%

Safety and Efficacy of Leadless Pacemakers: A New Era of Pacing

Ammari

Syed

Al-Sarie

et al. 2018

J Innov Cardiac Rhythm Manage.

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show abstract

“…39,40 Although HD patients were poorly represented in both the trials, available data suggest that the need to preserve veins for HD was one condition that precluded the use of a transvenous pacing system and use a leadless system. 41,42 In more demanding patients with indications to pacing and ICD, a combined therapy is also possible: SICD and leadless PM. However, no single trial on combined (leadless) therapy has been published; this concept was effective in one case report.…”

Section: Cied After Hd Accessmentioning

confidence: 99%

Section: Cied After Hd Accessmentioning

confidence: 99%

Cardiac implantable electronic device and vascular access: Strategies to overcome problems

Kusztal

Nowak

2018

J Vasc Access

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For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter. Fortunately, cardiac electrotherapy is moving toward miniaturization and less transvenous wires. Whenever feasible, one should avoid transvenous leads and choose alternative options such as subcutaneous implantable cardioverter defibrillator, epicardial leads, and leadless pacemaker. Based on recent reports on the leadless pacemaker/implantable cardioverter defibrillator effectiveness, in patients with rapid progression of chronic kidney disease (high risk of renal failure) or glomerular filtration rate <20 mL/min/1.73 m, this option should be considered by the implanting cardiologist for future access protection.

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“…The Micra TM TPS is a 0.8 cm 3 , 2.0 g capsule, 25.9 mm in length and an outer diameter of 6.7 mm that has features of a single-chamber pacemaker system. It is implanted in the right ventricle via a steerable transfemoral catheter delivery system using a 23 French introducer [5]. Due to its implantation into the myocardial wall via the femoral vein, the main sources of potential complications (e.g., subcutaneous pockets, permanent leads) are eliminated [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Visualization and appearance of artifacts of leadless pacemaker systems in cardiac MRI

Edlinger

Granitz

Paar

et al. 2018

Wien Klin Wochenschr

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SummaryBackgroundLeadless pacemaker systems are an important upcoming device in clinical rhythmology. Currently two different products are available with the Micra system (Medtronic) being the most used in the clinical setting to date. The possibility to perform magnetic resonance imaging (MRI) is an important feature of modern pacemaker devices. Even though the Micra system is suitable for MRI, little is yet known about its impact on artifacts within the images.ObjectiveThe aim of our ex vivo study was to perform cardiac MRI to quantify the artifacts and to evaluate if artifacts limit or inhibit the assessment of the surrounding myocardium.MethodsAfter ex vivo implantation of the leadless pacemaker (LP) in a porcine model, hearts were filled with saline solution and fixed on wooden sticks on a plastic container. The model was examined at 1.5 T and at 3 T using conventional sequences and T2 mapping sequences. In addition, conventional X‑rays and computed tomography (CT) scans were performed.ResultsCorrect implantation of the LP could be performed in all hearts. In almost all MRI sequences the right ventricle and the septal region surrounding the (LP) were altered by an artifact and therefore would sustain limited assessment; however, the rest of the myocardium remained free of artifacts and evaluable for common radiologic diagnoses. A characteristic shamrock-shaped artifact was generated which appeared to be even more intense in magnitude and brightness when using 3 T compared to 1.5 T.ConclusionThe use of the Micra system in cardiac MRI appeared to be feasible. In our opinion, it will still be possible to make important clinical cardiac MRI diagnoses (the detection of major ischemic areas or inflammatory processes) in patients using the Micra system. We suggest the use of 1.5 T as the preferred method in clinical practice.

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Transcatheter leadless cardiac pacing

Cited by 25 publications

References 27 publications

Safety and Efficacy of Leadless Pacemakers: A New Era of Pacing

Safety and Efficacy of Leadless Pacemakers: A New Era of Pacing

Cardiac implantable electronic device and vascular access: Strategies to overcome problems

Visualization and appearance of artifacts of leadless pacemaker systems in cardiac MRI

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