Wireless Communication Between Paired Leadless Pacemakers for Dual-Chamber Synchrony. (19th July 2022)

• Record Type: Journal Article
• Authors: Cantillon, Daniel J.; Gambhir, Alok; Banker, Rajesh; Rashtian, Mayer; Doshi, Rahul; Badie, Nima; Booth, Daniel; Yang, Weiqun; Nee, Peter; Fishler, Matthew; Ligon, David; Neuzil, Petr; Knops, Reinoud E.
• Is Part Of: Circulation. Volume 15:Number 7(2022)
• Page Start: e010909
• Publication Date: 2022-07-19
• Subjects: communication -- complications -- feasibility study -- pacemaker, artificial -- sheep; Arrhythmia -- Periodicals; Heart -- Electric properties -- Periodicals; 616.128
• DOI: 10.1161/CIRCEP.122.010909
• Languages: English
• ISSNs: 1941-3149

Abstract

Abstract : Background: Leadless pacemakers (LPs) can mitigate conventional pacemaker complications related to the transvenous leads and subcutaneous pocket surrounding the pulse generator. Although single-chamber leadless pacing has been established, multichamber pacing requires wireless bidirectional communication across multiple LPs to maintain synchrony. This preclinical study demonstrates the chronic performance of implant-to-implant (i2i) communication that achieves synchronous, dual-chamber pacing with 2 LPs. Methods: The i2i communication modality employs subthreshold electrical signals conducted between implanted LPs through the blood and myocardial tissue on a beat-by-beat basis. Right atrial and right ventricular LPs were implanted in 9 ovine subjects. The i2i transmission performance was evaluated 13 weeks after implant. Results: Right atrial and right ventricular LPs were implanted successfully and without complication in 9 ovine subjects. A total of 8715±457 right atrial-to-right ventricular and right ventricular-to-right atrial transmissions were sent per hour, with a success rate of 99.2±0.9%. Of periods with i2i communication failure when DDD pacing was not possible, 97.3±1.8% were resolved within 6 s. Conclusions: For the first time, synchronized, dual-chamber pacing has been demonstrated in a chronic preclinical feasibility study by 2 leadless pacemakers using beat-to-beat, wireless communication, achieving a success rate of 99.2%.