Opinion Article - Journal of Cholesterol and Heart Disease (2023) Volume 7, Issue 3
Interventional Therapies for Bradycardia: A Review of Pacemaker Implantation Techniques and Alternatives
Tobias Chao *
Department of Cardiology, University of Bern, Bern, Switzerland
- *Corresponding Author:
- Tobias Chao
Department of Cardiology,
University of Bern,
Received: 31-May-2023, Manuscript No. AACHD-23-101700; Editor assigned: 03-Jun-2023, PreQC No. AACHD-23-101700(PQ); Reviewed: 17-Jun-2023, QC No. AACHD-23-101700; Revised: 22-Jun-2023, Manuscript No. AACHD-23-101700; Published: 29-Jun-2023, DOI:10.35841/ aachd-7.3.149
Stroke is a devastating neurological condition characterized by a sudden disruption of blood supply to the brain, resulting in significant morbidity and mortality. Accurate and timely diagnosis of stroke is crucial for initiating appropriate treatment strategies and improving patient outcomes. In recent years, significant advancements in imaging techniques have revolutionized the diagnosis and assessment of stroke. Overview of the imaging modalities commonly employed in stroke diagnosis, including computed tomography (CT), magnetic resonance imaging (MRI), and angiography. Additionally, we discuss the emerging role of advanced imaging techniques such as diffusion-weighted imaging (DWI), perfusion imaging, and magnetic resonance angiography (MRA) in enhancing diagnostic accuracy and facilitating the evaluation of stroke severity, location, and underlying etiology. Furthermore, we explore the potential of artificial intelligence (AI) and machine learning (ML) algorithms in analyzing stroke imaging data and predicting patient outcomes. The integration of these innovative imaging techniques into clinical practice holds great promise for optimizing stroke management, guiding therapeutic decisions, and improving patient care .
Bradycardia is a prevalent cardiac disorder associated with various etiologies, including age-related degeneration, cardiac conduction system abnormalities, medication side effects, and genetic predispositions. Interventional therapies are essential in restoring and maintaining an appropriate heart rate in affected individuals. This article reviews the current landscape of pacemaker implantation techniques and explores innovative alternatives that have emerged in recent years. Bradycardia is a cardiac condition characterized by an abnormally slow heart rate, which can lead to a variety of symptoms ranging from mild fatigue to life-threatening complications. Interventional therapies play a crucial role in managing bradycardia, with pacemaker implantation being the most common and effective treatment option. This article aims to provide a comprehensive review of pacemaker implantation techniques, including advancements in device technology, implantation procedures, and emerging alternatives to traditional pacemakers .
Pacemaker implantation techniques
Discussing the positioning of leads in the right atrium and ventricle, the selection of appropriate pacing sites, and lead fixation methods. Highlighting advancements in pacemaker technology, including single-chamber, dual-chamber, and biventricular pacemakers. Describing the steps involved in transvenous pacemaker implantation, such as venous access, lead placement, pocket creation, and device programming. Exploring the evolution of leadless pacemakers, their miniature size, and the absence of transvenous leads. Examining the implantation procedure for leadless pacemakers, including delivery catheter insertion, device placement, and device retrieval options. Investigating the subcutaneous implantation of pacemakers without intravascular leads, including device selection and implantation considerations. Assessing the advantages and disadvantages of subcutaneous pacemakers compared to transvenous pacemakers .
Discussing the procedural nuances of His bundle pacing and the challenges associated with electrode placement. Investigating the use of wireless technology to power implanted devices, eliminating the need for batteries and potential device replacements. Examining the current status of wireless energy transfer systems, including technical considerations and safety concerns .
Clinical outcomes and complications
Reviewing the clinical outcomes and long-term benefits of pacemaker therapy for bradycardia patients. Discussing common complications associated with pacemaker implantation and strategies for their prevention and management .
Interventional therapies, particularly pacemaker implantation, continue to be the gold standard for managing bradycardia. Transvenous pacemakers remain the most widely used method, but emerging alternatives such as leadless pacemakers, subcutaneous pacemakers, His bundle pacing, and wireless energy transfer systems offer new opportunities for improved patient care. Continued research and advancements in interventional techniques will undoubtedly shape the future of bradycardia treatment, aiming for enhanced.
- Heckman L, Vijayaraman P, Luermans J, et al. Novel bradycardia pacing strategies. Heart 2020;106(24):1883-9.
- Li Y, Chen K, Dai Y, et al. Left bundle branch pacing for symptomatic bradycardia: Implant success rate, safety, and pacing characteristics. Heart Rhyth. 2019;16(12):1758-65.
- Tse G, Liu T, Laxton V, et al. Tachycardia-bradycardia syndrome: Electrophysiological mechanisms and future therapeutic approaches. Int J Mol Med. 2017;39(3):519-26.
- Sidhu S, Marine JE. Evaluating and managing bradycardia. Trends Cardiovasc. Med. 2020;30(5):265-72
- Yu CM, Chan JY, Zhang Q, et al. Biventricular pacing in patients with bradycardia and normal ejection fraction. N Engl J Med. 2009;361(22):2123-34.