Simultaneous Leadless Pacemaker and Subcutaneous ICD Implantation With Intraoperative Screening: Workflow in Two...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Patients requiring both pacing and implantable cardioverter-defibrillator (ICD) therapy face challenges with existing systems.
• Development of a communicating subcutaneous ICD and leadless pacemaker system aims to address these needs.
• Ensuring appropriate sensing of paced waveforms by the subcutaneous ICD is critical for device function and patient safety.

Observation:

• Two patient cases are presented to illustrate the approach and workflow for integrating a leadless pacemaker with a subcutaneous ICD.
• The focus is on verifying the sensing capabilities of the subcutaneous ICD in response to pacing from the leadless pacemaker.

Findings:

• The presented cases demonstrate a viable workflow for assessing the sensing of paced morphology by a subcutaneous ICD in a combined leadless pacemaker system.
• Successful integration and appropriate sensing were observed, validating the approach.

Implications:

• This approach facilitates the development and clinical implementation of combined leadless pacemaker and subcutaneous ICD systems.
• It offers a potential solution for patients needing both bradycardia pacing and defibrillation therapy.
• Further validation in larger cohorts is warranted to confirm safety and efficacy.