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Cleveland Clinic Journal of Medicine

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Article

Leadless cardiac pacing: What primary care providers and non-EP cardiologists should know

Erich L. Kiehl, MD and Daniel J. Cantillon, MD, FACC, FHRS
Cleveland Clinic Journal of Medicine November 2016, 83 (11 suppl 2) S24-S34; DOI: https://doi.org/10.3949/ccjm.83.s2.04
Erich L. Kiehl
Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic
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Daniel J. Cantillon
Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic
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  • For correspondence: [email protected]
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  • FIGURE 1
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    FIGURE 1

    Common transvenous pacemaker lead and pocket-related complications.

    Source: Lead fracture and pocket infection images courtesy of Dr. Mohamed Kanj. Hematoma image courtesy of Dr. John Rickard.

  • FIGURE 2
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    FIGURE 2

    Leadless pacemakers (A) Nanostim and (B) Micra.

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    FIGURE 3

    Fluoroscopic images depicting catheter-based deployment and subsequent release for the (A) Nanostim and (B) Micra.

  • FIGURE 4
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    FIGURE 4

    Frontal-plane radiographs showing implanted Nanostim (A) and Micra (B) leadless pacing devices and a traditional dual-chamber pacemaker (C). Panel D depicts cardiac deployment.

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    TABLE 1

    Overview of leadless pacemakers Nanostim and Micra based on completed human trials

    NanostimMicra
    ManufacturerSt. Jude MedicalMedtronic
    Size (height × width)42.0 × 6.0 mm25.9 × 6.7 mm
    Volume1.0 mL0.8 mL
    Mass2 g2 g
    Delivery sheath size18 F23 F
    Primary fixation mechanismHelixTines
    Projected battery lifea15.0 years12.5 years
    Remote monitoringNoYes
    Rate-responsive pacingYes, temperature-basedYes, accelerometer-based
    Retrieval systemYesNo
    • ↵a Based on reported projections at 3 months.

    • Data from references 21–27.

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Cleveland Clinic Journal of Medicine: 83 (11 suppl 2)
Cleveland Clinic Journal of Medicine
Vol. 83, Issue 11 suppl 2
1 Nov 2016
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Leadless cardiac pacing: What primary care providers and non-EP cardiologists should know
Erich L. Kiehl, Daniel J. Cantillon
Cleveland Clinic Journal of Medicine Nov 2016, 83 (11 suppl 2) S24-S34; DOI: 10.3949/ccjm.83.s2.04

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Leadless cardiac pacing: What primary care providers and non-EP cardiologists should know
Erich L. Kiehl, Daniel J. Cantillon
Cleveland Clinic Journal of Medicine Nov 2016, 83 (11 suppl 2) S24-S34; DOI: 10.3949/ccjm.83.s2.04
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  • Article
    • ABSTRACT
    • WHY LEADLESS PACING?
    • LEADLESS PACING TECHNOLOGY
    • ADVANTAGES OF LEADLESS PACING
    • END-OF-SERVICE QUESTIONS: ATTEMPT RETRIEVAL OR NOT?
    • OTHER LIMITATIONS AND CAUTIONARY NOTES
    • FUTURE DIRECTIONS
    • CONCLUSIONS
    • Footnotes
    • REFERENCES
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