- Electrodeless stimulation, which has similar efficacy to classical stimulation, gives us more protection for the patient. For one thing, we don't have electrodes, meaning we avoid the problems associated with them - damage or venous obstruction issues. On the other hand, the system, which is only located in the heart cavity, has a lower risk of infectious complications," says Prof. Marcin Grabowski, head of the Department of Cardiology at the University Clinical Center of Warsaw Medical University, in an interview with Medexpress.
Eletrodless stimulation gives more protection to the patient
Published Jan. 30, 2025 08:34
What are the benefits of modern electrodeless cardiac pacing, both from the clinicians' point of view, as well as, and perhaps most importantly, from the patients' comfort and safety?
Electrodeless cardiac pacing is the answer to current electrotherapy needs. First, it is a matter of preventing problems and complications. We know that patients with long-standing classical systems can have problems with implanted electrodes. These include damage to the electrodes, but they are also at risk of infectious complications. Electrodeless pacing, which has similar efficacy to classical pacing, gives us more protection for the patient. For one thing, we don't have electrodes, meaning we avoid the problems associated with them - damage or venous obstruction issues. On the other hand, the system, which is only located in the heart cavity, has a lower risk of infectious complications.
So this method responds to today's needs, but above all it prevents problems. From the patient's perspective, it also gives some comfort, related to convenience. It is smaller, localized only in the heart cavities. The patient does not experience potential discomfort in the locus, in the subclavian region, and we do not have electrodes inserted into the venous bed. We save the venous bed, which can be very important if in the future the patient will require dialysis, that is, will require vascular accesses. For us operators, this is an innovation, this is a new technology, very interesting from the perspective of access, the way this method is delivered. Vascular access is a common trend in interventional cardiology today. For us, this method is not only interesting, but also more efficient than the classic surgical approach.
Until now, ventricular-atrial dual-chamber pacing was only possible with traditional pacemakers. Nowadays, a modern, advanced electrodeless dual-chamber pacing system is available. To what extent does electrodeless dual-chamber pacing increase the effectiveness of treatment, and also how does this translate into patient safety?
The possibility of dual-chamber pacing is a new opening in this technology. Until now, the capabilities of the electrodeless pacemaker were limited to ventricular pacing. Admittedly, we had the ability to use this in many patients, but in some we had limitations, or it could even cause some adverse effect. In a patient who has sinus rhythm, in a patient who has heart failure, the use of asynchronous ventricular pacing could even lead to an exacerbation of the symptoms, which the patient would experience as a worsening of the comfort of life, a worsening of performance. The ability to achieve atrioventricular synchrony in terms of sensing in terms of control, but in addition the ability to achieve atrial pacing, which is this latest technology, gives us the ability to mirror the classic pacing system that we have been using for most patients so far. This major limitation, which was the lack of sensing and atrial pacing, has been overcome This is a new opening, and we can say today that the electrodeless dual-chamber pacemaker can be an alternative for most patients who have indications for classic dual-chamber pacing.
