Leadless Pacing: Current State and Future Direction

AbstractLeadless pacing is now an established alternative to conventional pacing with subcutaneous pocket and transvenous lead for patients with class I or II single-chamber pacing indication. Available 12-month follow-up data shows a 48% fewer major complication rate in patients with Micra ™ compared to a historical control group in a nonrandomized study [1]. There is one system with Food and Drug Administration (FDA) approval and two with the Communaut é Européenne (CE) mark. The OPS code for the implantation is 8–83d.3 and the procedure has recently been rated as a “new Examination and Treatment Method (NUB)” in the German DRG system, meaning adequate reimbursement is negotiable with health insurance providers. The systems offer similar g enerator longevity and programming possibilities as conventional pacemaker systems, including rate response, remote monitoring, and MRI safety. The biggest downsides to date are limitations to single-chamber stimulation, lack of long-time data, and concerns of handling of the system at the end of it s life span. However, implant procedure complication rates and procedure times do not exceed conventional pacemaker operations, and proper training and patient selection is provided.
Source: Cardiology and Therapy - Category: Cardiology Source Type: research