Leadless pacemakers: A review of current data and future directions

Leadless pacemakers (LPs) have revolutionized the field of pacing by miniaturizing pacemakers and rendering them completelty intracardiac, hence reducing complications related to pacemaker pockets and transvenous leads. However, first generation LPs appear to be associated with a higher rate of myocardial perforation as com-pared to transvenous pacemakers (TV-PPM). Currently, LPs are predominantly designed to pace the right ventri-cle with no LPs that provide atrial or biventricular pacing. In this article, we review the available data on LPs while advocating for the need for a randomized controlled trial comparing LPs to TV-PPMs. In addition, we review the future directions of leadless devices. (c) 2021 Elsevier Inc. All rights reserved.