Leadless Pacemakers

A leadless pacemaker is a type of pacemaker that is designed to be implanted directly into the heart without the need for leads, which are thin wires that are typically used to transmit electrical signals from the pacemaker to the heart.
Leadless pacemakers are much smaller than traditional pacemakers, typically about the size of a coin. They are inserted into the heart through a vein in the leg using a catheter, which is a long, thin tube. Once in place, the pacemaker delivers electrical impulses to the heart to regulate the heartbeat.
Fig 61Leadless pacemaker بطارية تنظيم ضربات القلب بدون أسلاك1
One of the main advantages of leadless pacemakers is that they are less invasive than traditional pacemakers, since they do not require leads to be implanted into the heart. This can improve cosmetic outcomes and reduce the risk of complications such as infection or damage to the heart tissue. They are a good option for bed bound, frail patients who are often at higher risk of infection. Another advantage is that leadless pacemakers can be used when the veins that are typically used for lead implant are occluded. The main disadvantage of leadless pacemakers is their high cost and that they are currently limited to only single-chamber ventricular pacing. With continuing research and development, it is very likely that leadless pacing will become a more prominent form of pacing in the future.
However, leadless pacemakers are not appropriate for all patients. Patients who require dual-chamber pacing may not be suitable to receive a leadless pacemaker. Additionally, these devices may not be a good option for young patients requiring frequent pacing as they will drain the battery quickly and there is a limitation on the number of these pacemakers that could implanted in the heart before affecting its function. Finally, leadless pacemakers are still a relatively new technology, and there is limited long-term data on their safety and effectiveness. Traditional pacemakers have been in use for many decades and have a well-established track record of safety and efficacy.
Overall, the decision to implant a leadless pacemaker should be made on an individual basis by a patient’s electrophysiologist, taking into account the patient’s medical history, current heart condition, and individual risk factors.