Leadless pacemakers (LPs) are self-contained pacemakers implanted inside the heart, providing a clinical strategy of pacing without pacemaker leads or a subcutaneous pocket. From an experimental therapy first used clinically in 2012, a decade later this technology is an established treatment option. Because of technologic advances and growing evidence, LPs are increasingly being used. Herein, the experience gained from a decade of leadless pacing is reviewed. We cover the safety and efficacy of single-chamber LPs, including comparisons with transvenous pacemakers and various models, and the initial clinical results of the first dual-chamber LP system. Furthermore, evidence and considerations regarding the optimal replacement strategy will be covered. Finally, we discuss future device developments that may broaden indications, such as LPs communicating with subcutaneous implantable cardiac defibrillators and energy-harvesting LPs.

中文翻译：

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十年的无导联心脏起搏


无导线起搏器 （LP） 是植入心脏内的独立起搏器，提供了一种没有起搏器导线或皮下袋的临床起搏策略。从 2012 年首次在临床上使用的实验性疗法开始，十年后，这项技术已成为一种既定的治疗选择。由于技术进步和越来越多的证据，LP 的使用越来越多。本文回顾了从十年的无铅起搏中获得的经验。我们涵盖了单腔 LP 的安全性和有效性，包括与经静脉起搏器和各种模型的比较，以及第一个双腔 LP 系统的初步临床结果。此外，还将涵盖有关最佳替代策略的证据和考虑。最后，我们讨论了可能拓宽适应症的未来设备发展，例如 LP 与皮下植入式心脏除颤器和能量收集 LP 通信。