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Clinical Summaries

Circulation: Clinical Summaries

Original Research Put Into Perspective for the Practicing Clinician

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https://doi.org/10.1161/CIR.0000000000000039
Circulation. 2014;129:1457-1458
Originally published April 7, 2014
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    • Permanent Leadless Cardiac Pacing: Results of the LEADLESS Trial
    • Dominant Frequency Increase Rate Predicts Transition from Paroxysmal to Long-Term Persistent Atrial Fibrillation
    • Temporal Trends in Ischemic Heart Disease Mortality in 21 World Regions, 1980 to 2010: The Global Burden of Disease 2010 Study
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Permanent Leadless Cardiac Pacing: Results of the LEADLESS Trial

Although highly effective, conventional cardiac pacemakers are limited by potential short- and long-term complications related to either the transvenous leads or the subcutaneous pulse generator. Thus, there has been intense interest in developing leadless cardiac pacemakers. Although it has been >40 years since the first preclinical demonstration of a leadless pacemaker, this study represents the first example of completely self-contained leadless cardiac pacing in humans. Thirty-three patients, with a clinical indication for single-chamber pacing, underwent implantation of a novel leadless cardiac pacemaker (LCP) able to function in a VVIR mode. After femoral venous access, the LCP is advanced to the right ventricle by using an 18F delivery system, and is then affixed to the myocardial tissue with the screw-in helix. We report that the procedure is feasible (implant success rate of 97%) with a mean procedure duration of 28±17 minutes and a favorable safety profile (complication-free rate of 94%). After 3 months of follow-up, all measures of pacing performance (lead impedance, pacing, and sensing threshold) either improved or were stable within the acceptable range. By eliminating the need for the weakest link of conventional pacing systems (the lead), and the need for a subcutaneous pulse generator, as well, this report represents a paradigm shift in cardiac pacing. See p 1466

Dominant Frequency Increase Rate Predicts Transition from Paroxysmal to Long-Term Persistent Atrial Fibrillation

We have used a model of intermittent atrial tachypacing that resembles closely the situation in humans with atrial fibrillation (AF) in the absence of comorbidities such as left ventricular dysfunction …

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Circulation
April 8, 2014, Volume 129, Issue 14
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    • Temporal Trends in Ischemic Heart Disease Mortality in 21 World Regions, 1980 to 2010: The Global Burden of Disease 2010 Study
    • The Global Burden of Ischemic Heart Disease in 1990 and 2010: The Global Burden of Disease 2010 Study
    • Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts
    • Impact of S-Adenosylmethionine Decarboxylase 1 on Pulmonary Vascular Remodeling
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    Circulation: Clinical Summaries
    Circulation. 2014;129:1457-1458, originally published April 7, 2014
    https://doi.org/10.1161/CIR.0000000000000039

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    Circulation. 2014;129:1457-1458, originally published April 7, 2014
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