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

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• 作者：Malini Madhavan ; MBBS ; Siva K. Mulpuru ; MD ; Christopher J. McLeod ; MBChB ; PhD ; Yong-Mei Cha ; MD ; Paul A. Friedman ; MD ; ^{pfriedman@mayo.edu}
• 关键词：His bundle pacing ; leadless pacing ; remote monitoring ; resynchronization
• 刊名：Journal of the American College of Cardiology
• 出版年：2017
• 出版时间：17 January 2017
• 年：2017
• 卷：69
• 期：2
• 页码：211-235
• 全文大小：8280 K
• 卷排序：69

文摘

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.