[Modular heart rhythm management : EMPOWER™ leadless pacemaker as an add-on to the EMBLEM™ S-ICD]

Technological advances in medicine now enable wireless antibradycardia myocardial stimulation. Leadless pacemakers (LP) have already been introduced by Abbott (Abbott Park, IL, USA; Nanostim™, Aveir™), Medtronic (Minneapolis, MN, USA; Micra AV/VR™), and most recently by Boston Scientific (Marlborough, MA, USA; EMPOWER™). Although case reports have been published using different LP in combination with the EMBLEM™ S‑ICD, only the EMPOWER™ LP provides the technological prerequisites for modular cardiac rhythm management (mCRM). In this modular system, an ATP command can be transmitted from the S‑ICD to the LP when required, potentially reducing the number of S‑ICD shocks. Additionally, long-term antibradycardia pacing can be reliably ensured. Following extensive preclinical studies, the 6‑month results of the first prospective multicenter study (MODULAR-ATP) are now available, analyzing the safety, performance, and necessity of the mCRM system.