Advances and Future Directions in Cardiac Pacemakers: Part 2 of a 2-Part Series
The Present and Future
State-of-the-Art Review
Advances and Future Directions in Cardiac Pacemakers: Part 2 of a 2-Part Series
The Present and Future
State-of-the-Art Review
Abstract
In the second part of this 2-part series on pacemakers, we present recent advances in pacemakers and preview future developments. Cardiac resynchronization therapy (CRT) is a potent treatment for heart failure in the setting of ventricular dyssynchrony. Successful CRT using coronary venous pacing depends on appropriate patient selection, lead implantation, and device programming. Despite optimization of these factors, nonresponse to CRT may occur in one-third of patients, which has led to a search for alternative techniques such as multisite pacing, His bundle pacing, and endocardial left ventricular pacing. A paradigm shift in pacemaker technology has been the development of leadless pacemaker devices, and on the horizon is the development of batteryless devices. Remote monitoring has ushered in an era of greater safety and the ability to respond to device malfunction in a timely fashion, improving outcomes.
Key Words
His bundle pacing
leadless pacing
remote monitoring
resynchronization
Abbreviations and Acronyms
CRT
cardiac resynchronization therapy
LBBB
left bundle branch block
LV
left ventricle/ventricular
RBBB
right bundle branch block
RV
right ventricle/ventricular
TTM
transtelephonic monitoring
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Dr. Friedman receives research support from St. Jude Medical; and is a consultant and advisory board member for Medtronic and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
© 2017 by the American College of Cardiology Foundation. Published by Elsevier.