The projected system longevity reaches more than eight years in most patients. After initial setbacks due to implantation- and device-related adverse events, leadless pacemaker technology was soon shown to be effective. In 2012, the first-in-man implantation of a right ventricular leadless pacemaker was performed. His bundle pacing or left bundle branch area pacing ). Thus, recent innovations in the field aimed at removing the Achilles’ heel of conventional systems (leadless pacing) or providing a more physiological way of ventricular activation (cardiac resynchronisation therapy or conduction system pacing, i.e. Besides system failures, patients may also develop pacing-induced cardiomyopathy due to unphysiological ventricular stimulation. However, more than 20% of patients experience complications within five years after implantation, mostly related to the pacing leads. Transvenous PM implantation is considered a relatively safe long-term therapy. The adoption of refined implantation techniques such as axillary vein (instead of subclavian vein) puncture or septal (instead of apical) lead placement is strongly recommended and has the potential to further reduce adverse events such as pneumothoraces or cardiac perforations. significant pocket haematoma, lead dislocation or perforation, pneumothorax, acute infection) are under 5% in the hands of experienced operators. Complications within two month after implantation requiring an intervention (e.g. Dual chamber systems, featuring an additional atrial lead, allow atrioventricular (AV) synchrony. ![]() Venous access is gained via the left or right subclavian vein, the PM lead is advanced into the RV cavity and connected to a pulse generator in the pectoral pocket. Transvenous RV pacing is widely available in hospitals throughout Switzerland due to its ease of implantation. The longevity of current pacemaker (PM) systems is in many cases more than a decade. It is an established and effective therapy restoring heart rate and improving bradycardia-induced symptoms. ![]() Right ventricular (RV) apical pacing has been the cornerstone of cardiac pacing for bradycardia-induced symptoms since its introduction. The goal of this mini-review is to provide an overview on contemporary pacing techniques, their most common uses and limitations. Subsequently, the European Society of Cardiology has recently updated guidelines on cardiac pacing. In the past decade, cardiac pacing techniques evolved significantly – resulting in a large variety of available approaches that are used to tailor stimulation individually to the patient’s needs. ![]() A Department of Cardiology, Bern University Hospital (Inselspital), University of Bern, Switzerland b ARTORG Centre for Biomedical Engineering Research, University of Bern, Switzerland
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