Wireless Connection Between ICD and Pacemaker Feasible

Subcutaneous implantable cardioverter defibrillators (ICDs) and leadless cardiac pacemakers can be networked without leads in wireless multi-device systems, a preclinical trial suggested.

The proof of concept study showed ATP-enabled leadless cardiac pacemakers, delivered percutaneously to the right ventricular apex, communicating with paired ICDs without any intravenous leads.

That "intrabody, wireless, unidirectional communication between both devices was successful" marks "a first step toward establishing multicomponent device systems that eliminate transvenous leads," Fleur V.Y. Tjong, MD, of Amsterdam's Academic Medical Center, and colleagues reported in the Journal of the American College of Cardiology.

"Future technology directions could include bidirectional communication that allows rhythm confirmation by the leadless cardiac pacemaker to enhance subcutaneous ICD rhythm discrimination and minimize inappropriate shocks," the investigators wrote online.

As the study was conducted in two sheep, however, the authors acknowledged that they were limited by the use of an animal model and a very small sample size. In addition, the findings stemmed from their use of prototype technology, they noted.

Indeed, "further investigation of the subcutaneous ICD rhythm discrimination during intrinsic rhythm, ventricular tachyarrhythmias, leadless cardiac pacemaker pacing, and conducted communication is warranted," the authors concluded, adding that "the behavior of the leadless cardiac pacemaker during ventricular fibrillation and the effect on subcutaneous ICD sensitivity for ventricular fibrillation require rigorous study" in particular.

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