[The leadless pacemaker system: present applications and future perspectives]

Cardiac devices are ever evolving, since 1958 we have come a long way from Senning's and Elmqvist's ingenious but crude first implantable pacemaker. The leadless intracardiac pacemaker (weight 2 grams) can be implanted in its entirety in the right ventricle through a femoral transcatheter approach. Currently, the leadless pacemaker system only offers VVI-mode. Studies show promising results, with lower complication rates than transvenous pacemaker systems. To date, there are no randomized controlled studies comparing leadless and transvenous pacemakers and no long-term follow-up. Due to this, high cost, and lack of experience, for now, leadless pacemakers can only be recommended for patients with indication for VVI pacemaker and in whom transvenous pacemaker leads are unfeasible. To illustrate this, we describe a case where a leadless pacemaker provided the solution to difficult venous access.