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2017 ; 6
(2
): 175-181
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Leadless Pacing: Current State and Future Direction
#MMPMID28707043
Merkel M
; Grotherr P
; Radzewitz A
; Schmitt C
Cardiol Ther
2017[Dec]; 6
(2
): 175-181
PMID28707043
show ga
Leadless pacing is now an established alternative to conventional pacing with
subcutaneous pocket and transvenous lead for patients with class I or II
single-chamber pacing indication. Available 12-month follow-up data shows a 48%
fewer major complication rate in patients with Micra? compared to a historical
control group in a nonrandomized study [1]. There is one system with Food and
Drug Administration (FDA) approval and two with the Communauté Européenne (CE)
mark. The OPS code for the implantation is 8-83d.3 and the procedure has recently
been rated as a "new Examination and Treatment Method (NUB)" in the German DRG
system, meaning adequate reimbursement is negotiable with health insurance
providers. The systems offer similar generator longevity and programming
possibilities as conventional pacemaker systems, including rate response, remote
monitoring, and MRI safety. The biggest downsides to date are limitations to
single-chamber stimulation, lack of long-time data, and concerns of handling of
the system at the end of its life span. However, implant procedure complication
rates and procedure times do not exceed conventional pacemaker operations, and
proper training and patient selection is provided.
free
free
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