《Leadless PacingThe Next Era in Bradycardia Therapy》.pptVIP

Leadless Pacing:The Next Era in Bradycardia Therapy 郭航远 绍兴市人民医院 Innovation S-curve in Implantable Bradycardia Therapy Breakthrough Innovation in Medical Devices Megatrends/Healthcare Trends Signal Need for New Solutions Increased demand for—and access to—healthcare: Global aging/chronic disease Urbanization Rise of Asia More price pressure in healthcare Technology convergence Nanotechnology Biotechnology Information technology (internet/digital ubiquity) Enabling Technologies Catheter-based therapies PCI/peripheral/endovascular interventions Structural heart repair (TCV, ASD, PFO, etc.) Ablation Technical Challenges in Leadless Pacing:Not for the Faint of Heart! Fixation technology Superior holding force, but enable repositioning/retrieval Delivery systems Novel power sources Increased electronic packaging density Biocompatible device packaging Lifetime hermeticity Electrode-tissue interface; low, stable pacing thresholds Ultra-low power circuitry Surface coatings Rate response-intracardiac Communication systems: External (telemetry; wireless) Inter-device (intrabody) New implant procedure Potential Clinical Risks Fixation/dislodgement Large-bore catheters Access challenges Hemostasis Vascular complications Low, stable chronic thresholds Thromboembolic risk Extraction? Other Potential Approaches Energy transfer Acoustic Induction Rechargeable? Epicardial? The Next S-curves In Bradycardia Therapy Conclusions Physicians---and industry—have envisioned leadless pacing for over 40 years Societal megatrends/healthcare trends and unmet needs in cardiac pacing make it even more desirable today Technological advances/convergence have now made the concept realizable Effective implementation will require extensive integration of numerous technology systems The clinical benefits must outweigh the risks Leadless Pacing Using Induction Thank You! * * Technological performance often follows an S-shaped curve Performance Effort (funds) and/or Time Physical li