The importance of leadless pacemaker positioning in relation to subcutaneous implantable cardioverter-defibrillator sensing in completely leadless cardiac resynchronization and defibrillation systems

Elliott, Mark K.; Sidhu, Baldeep S.; Mehta, Vishal; Gould, Justin; Martic, Dejana; Rinaldi, Christopher A.

doi:10.1016/j.hrcr.2021.06.006

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…It was recently reported that implanting another leadless pacemaker in a different location in the RV was suboptimal in patients with a coexistent S-ICD. 6 Hence, in the present case, the implantation site for the future replacement of the leadless pacemaker will be carefully selected.…”

Section: Discussionmentioning

confidence: 99%

Treatment Strategy for Fatal Arrhythmias in Ebstein’s Anomaly Combined With Leadless Pacemaker and S-ICD Implantations

Takami

Fukuzawa²,

Kiuchi³

et al. 2022

JACC: Case Reports

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Section: Discussionmentioning

confidence: 99%

Treatment Strategy for Fatal Arrhythmias in Ebstein’s Anomaly Combined With Leadless Pacemaker and S-ICD Implantations

Takami

Fukuzawa²,

Kiuchi³

et al. 2022

JACC: Case Reports

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“…Indeed, Boston Scientific has developed a hybrid LP (EMPOWER) plus s-ICD (EMBLEM) system that is able to provide anti-bradycardia pacing and anti-tachycardia pacing together with shocks 15 , and which is currently under investigation (Modular ATP trial, NCT04798768). In one case, a completely leadless CRT-D system was created by using an LP (Medtronic Micra TPS) combined with a WiSE-CRT system (EBR Systems, Sunnyvale, CA) and an s-ICD 16 . When conventional ICD lead implantation has proved impossible, other strategies have been adopted, such as the use of a hybrid subcutaneous and trans-venous CRT-D approach using the Medtronic 6996SQ Finger subcutaneous array lead 17 , and ICD lead implantation in the coronary sinus in the context of CRT-D 18 .…”

Section: Discussionmentioning

confidence: 99%

His-Optimized Cardiac Resynchronization Therapy (HOT-CRT) in a subcutaneous ICD patient: first-in-human case report

Dell’Aquila

Bontempi

Fundaliotis

et al. 2022

Preprint

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Recent developments in arrhythmology have enabled the use of new devices, such as subcutaneous implantable cardioverter-defibrillators (s-ICD), and the comeback of older strategies, such as His-Bundle pacing (HBP) in clinical practice, alongside the use of thoroughly proven therapies such as cardiac resynchronization therapy (CRT), e.g. with His-Optimized CRT (HOT-CRT). However, interplay between these new and older techniques is not always clear. We report the first-in-human case of biventricular pacemaker (CRT-P) implantation with HOT-CRT in an s-ICD patient. Paced QRS morphology was similar to the spontaneous morphology, albeit shorter. Correct QRS identification by the s-ICD was confirmed both intra-procedurally and post-procedurally.

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“…Since the systems do not communicate, ATP cannot be delivered. Additionally, there is a theoretical concern that the paced QRS may cause an increase in double counting or T wave oversensing, resulting in inappropriate S-ICD tachyarrhythmia detections and therapy [ 39 ].…”

Section: Limitationsmentioning

confidence: 99%

Leadless Pacemakers: State of the Art and Selection of the Ideal Candidate

Blank

El‐Chami

Wenger

2023

CCR

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The field of cardiac pacing has been defined by constant development to provide efficacious, safe, and reliable therapy. Traditional pacing utilizes transvenous leads, which dwell in the venous system and place patients at risk for complications, including pneumothorax, bleeding, infection, vascular obstruction, and valvular compromise. Leadless pacemakers have been developed to overcome many of the challenges of transvenous pacing while providing safe and effective pacing therapy for an increasing population of patients. The Medtronic Micra transcatheter pacing system was approved by the FDA in April of 2016 and the Abbott Aveir pacemaker was approved in April of 2022. Several additional leadless pacemakers are in various stages of development and testing. There exists limited guidance on the selection of the ideal candidate for leadless pacemakers. Advantages of leadless pacemakers include decreased infection risk, overcoming limited vascular access, and avoidance of interaction with the tricuspid valve apparatus. Disadvantages of leadless pacemakers include right ventricular-only pacing, unclear lifecycle management, cost, perforation risk, and lack of integration with defibrillator systems. This review aims to provide an overview of the current state of the art of leadless pacemakers, currently approved systems, clinical trials and real-world evidence, considerations for patient selection, and future directions of this promising technology

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The importance of leadless pacemaker positioning in relation to subcutaneous implantable cardioverter-defibrillator sensing in completely leadless cardiac resynchronization and defibrillation systems

Cited by 6 publications

References 16 publications

Treatment Strategy for Fatal Arrhythmias in Ebstein’s Anomaly Combined With Leadless Pacemaker and S-ICD Implantations

Treatment Strategy for Fatal Arrhythmias in Ebstein’s Anomaly Combined With Leadless Pacemaker and S-ICD Implantations

His-Optimized Cardiac Resynchronization Therapy (HOT-CRT) in a subcutaneous ICD patient: first-in-human case report

Leadless Pacemakers: State of the Art and Selection of the Ideal Candidate

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