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Advances and Future Directions in Cardiac Pacemakers: Part 2 of a 2-Part Series

Elsevier

Journal of the American College of Cardiology

The Present and Future

State-of-the-Art Review

Advances and Future Directions in Cardiac Pacemakers: Part 2 of a 2-Part Series

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

Cited by (0)

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.