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Feature Article

New Leadless Pacemaker Offers Options

For people who have permanent atrial fibrillation and need a pacemaker, a leadless pacemaker offers a new option.

Traditional vs. Leadless Pacemakers

With a traditional pacemaker, a small generator is implanted in the shoulder area, with wires that lead to an electrode that is placed in the heart. The generator sends an electrical impulse through the wires to the electrode to regulate the heartbeat.

Leadless pacemakers are placed in the heart, but have no generator and no wires leading out of the heart. The device is self-contained and small about the size of a bullet. Because a leadless pacemaker is self-contained and is delivered to the heart through a catheter placed in a vein in the leg, there are fewer procedural risks and long-term complications.

“The real advantage of this technology is that it puts less hardware in people,” said Ross Downey, MD, a heart rhythm specialist at Samaritan Cardiology in the Samaritan Heart Center. “Once the device is in place, hopefully people don’t even realize they have it.”

Traditional and leadless pacemakers work by sensing the heart’s electrical activity. If the heart rhythm is slow, the device sends an electrical pulse to the heart to regulate and adjust the rhythm.

A leadless pacemaker is used for people who need ventricular pacing to regulate the speed of the heartbeat, or who have intermittent heart block where the heart occasionally pauses.

Not everyone is a good candidate for the device. The technology currently only supports pacing in the bottom chamber (ventricle) of the heart, so people with rhythm problems that require top chamber (atrial) pacing support will still need a traditional pacemaker. 

But a leadless pacemaker could still be in your future.

“The technology in this field is advancing quickly and we’re seeing a move to having various systems in the heart that all talk wirelessly between themselves and function without having the need for a traditional device in the upper chest,” said Downey. “This is the future.”

Learn more about heart and vascular services at Samaritan Heart Center.

Read more about arrhythmia.