[Leadless pacing: present and future of cardiac stimulation]

Leadless pacemaker therapy now represents a reality in the field of cardiac pacing. It was developed with the aim of reducing post-procedural complications due to endocavitary leads and with the intention to propose itself as a valid alternative in patients who have contraindications to conventional pacing. Leadless pacemakers to date allow right ventricular stimulation and are implanted through a percutaneous venous femoral access. Currently, the system available is the MicraTM Transcatheter Pacing System. On November 2017, the worldwide implants of the NanostimTM Leadless Pacemaker System were halted. These devices have shown promising results in the various clinical trials with complications mostly due to the implant procedure. In order to avoid these complications, a correct learning curve of the operators has resulted very important. Recently, a new system, the WiSE-CRT, has been introduced as a leadless alternative to cardiac resynchronization therapy. While the results of randomized trials and long-term follow-up studies are still pending, in this paper we will review the main clinical data that have been published to date, comparing them to the traditional devices for transvenous endocardial stimulation.