Leadless pacing: Presente e Futuro della stimolazione cardiaca

Leadless pacemaker therapy now represents a reality in the field of cardiac pacing. It was developed with the aim of reducing post-procedural complications due to endocavitary leads and with the intention to propose itself as a valid alternative in patients who have contraindications to conventional pacing. Leadless pacemakers to date allow right ventricular stimulation and are implanted through a percutaneous venous femoral access. Currently, the system available is the Micra ^TM Transcatheter Pacing System. On November 2017, the worldwide implants of the Nanostim ^TM Leadless Pacemaker System were halted. These devices have shown promising results in the various clinical trials with complications mostly due to the implant procedure. In order to avoid these complications, a correct learning curve of the operators has resulted very important. Recently, a new system, the WiSE-CRT, has been introduced as a leadless alternative to cardiac resynchronization therapy. While the results of randomized trials and long-term follow-up studies are still pending, in this paper we will review the main clinical data that have been published to date, comparing them to the traditional devices for transvenous endocardial stimulation.