Leadless Pacemakers: Where Do We Stand?

Leadless pacemakers have been designed to reduce both short and tong-term adverse events usually associated with standard pacemakers (adverse events due to the can or leads). Leadless pacemakers have a reduced size but include a tong life miniaturized battery. This design and their implantation during a mini-invasive procedure constitute a technological breakout. Published evidence supports this new technology with a low level of adverse events and good efficiency. Adverse events usually occur in the early post-implantation phase within 30 days and are rare after 30 days. Currently only the Medtronic Micra (TM) is implanted because the first leadtess pacemaker on the market was withdrawn due to a battery issue. Expert guidelines recommend VVI leadless pacing when standard access fails (venous occlusion) or in cases of high risk of infection. Further improvements comprise dual chamber leadless pacemaker, left ventricular leadless resynchronization and leadless pacemaker associated with the subcutaneous defibrillator. (C) 2020 l'Acadernie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.