Leadless Pacemakers
Patients
with severe/symptomatic bradycardia, an arrhythmia indicating an unusually slow
heart rate are treated by implantation of pacemakers. A pacemaker is
a device that sends small electrical impulses to the heart muscle to maintain a
suitable heart rate. Traditionally, pacemaker consists of a device which
houses all the electronic circuitry and battery, which is implanted under the
skin in the upper part of chest on left side or right side.
This
device is connected to leads which are inserted through a vein and carried up
to the right chambers of the heart. Pacemakers with single lead are called
single chamber pacemaker, which stimulate right ventricle only. Pacemakers with
two leads are called dual chamber pacemaker and stimulate right auricle and
right ventricle in succession.
Leadless
pacemaker devices are self-contained enclosed capsules that include the
pacemaker electronics and battery, and are delivered via catheter to the right
ventricle of the heart. Leadless pacemakers function similarly to
traditional single-chamber ventricular pacemakers without requiring transvenous
leads or the need for a surgical pocket. Dual chamber pacing is still not
possible with leadless pacemakers. It does not require connecting leads (wires)
or a generator, or a creation of a surgical pocket on the chest.
These
are the most common causes of traditional pacemaker complications over the
long-term. When the leadless device is in place, there is no lump under the
skin on the chest or leads anchored to the muscle bed. The procedure uses
a catheter to place the device. The procedure typically takes less time than a
traditional pacemaker implant procedure. Because there are no wires or
generator, one need not limit upper body activity after the implant.
Not
everyone is a candidate for a leadless pacemaker. Currently, the device is
available only for patients with certain medical conditions and a slow heart
rate (bradycardia) who need single-chamber pacing only.
Head
Of Department of Cardiology
Primus Super Specialty Hospital
Chanakyapuri,
New Delhi-110021
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