Leadless Pacemaker Implantation

BACKGROUND

A leadless pacemaker is a small implantable device that sends electrical pulses to the heart to maintain a suitable heart rate or to stimulate the lower chambers of the heart (ventricles). . Leadless pacing devices are placed directly in the heart without the need for a surgical pocket and insulated wires (called leads).

What are the benefits of a leadless pacemaker?

• It does not require connecting leads (wires) or a generator, or a creation of a surgical pocket on the chest.
• The procedure uses a catheter to place the device. The procedure typically takes less time than a traditional pacemaker implant procedure.

• Because there are no wires or generator, you do not need to limit upper body activity after the implant.

PROCEDURE INFORMATION

How does a leadless pacemaker work?

Unlike conventional pacemakers, a leadless pacemaker is placed directly in the heart without the need for a surgical pocket and pacing leads. The device is much smaller than a conventional pacemaker and is comprised of a pulse generator that includes a battery and a steroid-eluting electrode that sends pulses to the heart when it recognizes a problem with the heart’s rhythm.

Leadless pacemaker technology is made up of computer chips and a small, but long-lived battery in a sealed case that resembles an AAA battery. The device is implanted through a vein that passes fairly close to the outer surface of the upper thighs. Because the implant procedure does not require surgery like a traditional procedure, it is considered a less-invasive approach for patients who need pacemaker technology.

Who is a candidate for a leadless pacemaker?

Not everyone is a candidate for a leadless pacemaker. Currently, the device is available only for patients with certain medical conditions and a slow heart rate (bradycardia) who need single-chamber pacing only.

What happens after the procedure?

You will need to lie flat and keep the leg straight for two to six hours after the procedure. This prevents bleeding from the access site.  Do not try to sit or stand. A sterile dressing will be placed on your groin area to protect it from infection. You will spend the night in the hospital and will be able to go home after your device check and a chest X-ray.

RISK FACTOR

What are the risks of a leadless pacemaker implant?

Every procedure has complications associated with it.  The most common possible problems after a leadless pacemaker implant involve the incision site, such as swelling and bleeding. These are not typically life threatening but may lead to a longer hospital stay or slower recovery.

More serious but rare complications include the device moving out of place (dislodgement) or internal bleeding, such as pericardial effusion or tamponade.

Follow-up

Typically, your first follow-up appointment is one month after implant, with additional follow-ups every 6 months.Follow up after a leadless pacemaker is similar to a traditional schedule with non-invasive checks.