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Intracardiac wireless communication is crucial for the development of multi-chamber leadless cardiac pacemakers (LCP). However, the time-varying characteristics of intracardiac channel pose major challenges. As such, mastering the dynamic conduction properties of the intracardiac channel and modeling the equivalent time-varying channel are imperative for realizing LCP multi-chamber pacing.

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Leadless Cardiac Pacing: New Horizons.

Cardiol Ther

March 2023

Royal Brompton and Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1, UK.

Since the introduction of transvenous cardiac pacing leads, pacemaker system design has remained similar for several decades. Progressive miniaturisation of electronic circuitry and batteries has enabled a smaller, single pacing unit comprising the intracardiac electrodes, generator and computer. This review explores the development of leadless pacing, the clinical trials comparing leadless to transvenous pacing in addition to the future developments of multi-chamber leadless pacing.

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Conductive intracardiac communication (CIC) has been demonstrated as a promising concept for the synchronization of multi-chamber leadless cardiac pacemakers (LLPMs). To meet the 2-5 μW power budget of a LLPM, highly specialized CIC-transceivers, which make optimal use of the cardiac communication channel, need to be developed. However, a detailed investigation of the optimal communication parameters for CIC-based LLPM synchronization is missing so far.

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