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Advances in Pacemaker Implantation: Past, Present, and Future Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 2270

Special Issue Editors


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Guest Editor
Department of Clinical Cardiac Electrophysiology, HonorHealth, Scottsdale, AZ, USA
Interests: physiologic pacing; leadless pacing; lead management

E-Mail Website
Guest Editor Assistant
Department of Clinical Cardiac Electrophysiology, HonorHealth, Scottsdale, AZ, USA
Interests: physiologic pacing; leadless pacing; lead management

Special Issue Information

Dear Colleagues,

There has recently been a resurgence of excitement around technologies for cardiac pacing. Since the recognition of the deleterious effects of right ventricular-only pacing, physiologic pacing has rapidly gained traction in the use of traditional transvenous pacing systems, including when cardiac resynchronization therapy is indicated. With some of the early challenges regarding His-bundle pacing, the field has evolved to predominantly left bundle area pacing. Similarly, with the recognition of the negative sequelae of transvenous leads, both acute and chronic, including infection and malfunction requiring lead extraction but also tricuspid regurgitation, leadless pacing has rapidly gained acceptance, especially since the introduction of dual-chamber and atrial leadless pacing. Now, with the potential to marry these two technologies, with the introduction of both physiologic leadless pacing and leadless cardiac resynchronization therapy, the field of cardiac pacing may have the best of all possible worlds and better serve our patient population.

Prof. Dr. Rahul N. Doshi
Guest Editor

Dr. Ankur A. Karnik
Guest Editor Assistant

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Keywords

  • pacing
  • physiologic pacing
  • left bundle area pacing
  • leadless pacing
  • lead management

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Published Papers (1 paper)

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Review

27 pages, 2544 KB  
Review
Era of Synchronized Physiologic Leadless Pacing: A Novel Approach to Cardiac Pacing and Ongoing Development
by Dhan Bahadur Shrestha, Jurgen Shtembari, Daniel H. Katz, James Storey, Ashlesha Chaudhary, Anuj Garg and Ajay Pillai
J. Clin. Med. 2026, 15(3), 1251; https://doi.org/10.3390/jcm15031251 - 4 Feb 2026
Viewed by 2015
Abstract
Cardiac pacing has undergone a significant transformation in the last decade. Leadless pacing (LP), once only a conceptual idea stemming from the early interest in eliminating lead-related complications of transvenous pacemakers, has now become a reality in clinical practice. Since the introduction of [...] Read more.
Cardiac pacing has undergone a significant transformation in the last decade. Leadless pacing (LP), once only a conceptual idea stemming from the early interest in eliminating lead-related complications of transvenous pacemakers, has now become a reality in clinical practice. Since the introduction of the first human single-chamber asynchronous leadless ventricular pacing in 2012, atrioventricular-synchronized single- or dual-chamber leadless pacing systems have been approved for clinical use since 2020. Leadless cardiac resynchronization therapy (CRT) has shown optimistic results in case series and awaits its full utility in real-world clinical practice. With the successful feasibility study of leadless conduction system pacing, we are eagerly awaiting long-term safety and efficacy data on a large scale. Another important frontier is the development of self-rechargeable LP, which may be an ideal pacemaker for the future and may reduce the burden of multiple device replacements as batteries near the end-of-service. Totally extravascular percutaneous leadless pericardial micro-pacemaker system implantation is under development. In this state-of-the-art review, we examine the evolution of cardiac pacing, emphasizing the development and utility of LP to meet maximum physiological pacing needs, optimize atrioventricular synchrony and cardiac resynchronization, and broaden its indications. Full article
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