Perkutan Katheter-basiert implantierbare Herzschrittmacher

Zusammenfassung

Die elektrische Stimulation des Herzens ist heute die Standardtherapie bei symptomatischen Bradykardien. Trotz technischer Weiterentwicklungen stellen Komplikationen, welche im Zusammenhang mit konventionellen Schrittmacherelektroden und / oder Aggregattaschen stehen, noch immer eine relevante Herausforderung dar. Miniaturisierte, „elektrodenlose“ Schrittmacher könnten diese Limitationen teilweise überwinden. Darüber hinaus besteht die Möglichkeit für einige betroffene Patienten, kosmetische Vorteile zu nutzen und mit der Implantation verbundene körperliche Einschränkungen zu minimieren. Erste klinische Daten mit Ein-Kammer-Schrittmachern, welche über eine vollständige transfemorale Implantation eine rechtsventrikuläre Stimulation ermöglichen, sind in diesem Zusammenhang vielversprechend. „Elektrodenlose“ Schrittmacher stellen damit eine vielversprechende Erweiterung der kardialen „Elektrotherapie“ dar, obgleich der Langzeit-Verlauf von Patienten mit diesen innovativen Herzrhythmusimplantaten noch weiter untersucht werden muss.

Abstract

Electrical cardiac pacing today is the standard therapy for symptomatic bradycardia. Importantly, despite technical advantages, complications associated with conventional transvenous pacing leads and pockets are still challenging in a relevant number of patients. Beyond cosmetic benefits, miniaturized leadless pacemaker may partly overcome these limitations and beneficially influence implantation-related physical restrictions. Initial findings with single-chamber pacemakers for right ventricular pacing, which are completely implanted via a femoral venous vascular access, are promizing. In summary, leadless pacing offers novel perspectives regarding cardiac implantable electronic devices although acute safety and the long-term performance of these systems needs to be determined in more detail.

Schlüsselwörter

Leadless pacemaker - transcatheter pacemaker - atrial fibrillation - bradycardia

Keywords

elektrodenloser Herzschrittmacher - Schrittmacher - Vorhofflimmern - Bradykardie

• Literatur

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