Wireless Communication Between Paired Leadless Pacemakers for Dual-Chamber Synchrony

Daniel J. Cantillon, Alok Gambhir, Rajesh Banker, Mayer Rashtian, Rahul Doshi, Nima Badie, Daniel Booth, Weiqun Yang, Peter Nee, Matthew Fishler, David Ligon, Petr Neuzil, Reinoud E. Knops

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)

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%.
Original languageEnglish
Pages (from-to)e010909
JournalCirculation. Arrhythmia and electrophysiology
Volume15
Issue number7
DOIs
Publication statusPublished - 1 Jul 2022

Keywords

  • communication
  • complications
  • feasibility study
  • pacemaker, artificial
  • sheep

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