A Dual-Chamber Leadless Pacemaker.

Humans Atrial Fibrillation / therapy Atrioventricular Block / therapy Cardiac Pacing, Artificial / adverse effects Follow-Up Studies Pacemaker, Artificial / adverse effects Prospective Studies Treatment Outcome Arrhythmias, Cardiac / therapy

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
22 Jun 2023
Historique:
medline: 23 6 2023
pubmed: 22 5 2023
entrez: 22 5 2023
Statut: ppublish

Résumé

Single-chamber ventricular leadless pacemakers do not support atrial pacing or consistent atrioventricular synchrony. A dual-chamber leadless pacemaker system consisting of two devices implanted percutaneously, one in the right atrium and one in the right ventricle, would make leadless pacemaker therapy a treatment option for a wider range of indications. We conducted a prospective, multicenter, single-group study to evaluate the safety and performance of a dual-chamber leadless pacemaker system. Patients with a conventional indication for dual-chamber pacing were eligible for participation. The primary safety end point was freedom from complications (i.e., device- or procedure-related serious adverse events) at 90 days. The first primary performance end point was a combination of adequate atrial capture threshold and sensing amplitude at 3 months. The second primary performance end point was at least 70% atrioventricular synchrony at 3 months while the patient was sitting. Among the 300 patients enrolled, 190 (63.3%) had sinus-node dysfunction and 100 (33.3%) had atrioventricular block as the primary pacing indication. The implantation procedure was successful (i.e., two functioning leadless pacemakers were implanted and had established implant-to-implant communication) in 295 patients (98.3%). A total of 35 device- or procedure-related serious adverse events occurred in 29 patients. The primary safety end point was met in 271 patients (90.3%; 95% confidence interval [CI], 87.0 to 93.7), which exceeded the performance goal of 78% (P<0.001). The first primary performance end point was met in 90.2% of the patients (95% CI, 86.8 to 93.6), which exceeded the performance goal of 82.5% (P<0.001). The mean (±SD) atrial capture threshold was 0.82±0.70 V, and the mean P-wave amplitude was 3.58±1.88 mV. Of the 21 patients (7%) with a P-wave amplitude of less than 1.0 mV, none required device revision for inadequate sensing. At least 70% atrioventricular synchrony was achieved in 97.3% of the patients (95% CI, 95.4 to 99.3), which exceeded the performance goal of 83% (P<0.001). The dual-chamber leadless pacemaker system met the primary safety end point and provided atrial pacing and reliable atrioventricular synchrony for 3 months after implantation. (Funded by Abbott Medical; Aveir DR i2i ClinicalTrials.gov number, NCT05252702.).

Sections du résumé

BACKGROUND BACKGROUND
Single-chamber ventricular leadless pacemakers do not support atrial pacing or consistent atrioventricular synchrony. A dual-chamber leadless pacemaker system consisting of two devices implanted percutaneously, one in the right atrium and one in the right ventricle, would make leadless pacemaker therapy a treatment option for a wider range of indications.
METHODS METHODS
We conducted a prospective, multicenter, single-group study to evaluate the safety and performance of a dual-chamber leadless pacemaker system. Patients with a conventional indication for dual-chamber pacing were eligible for participation. The primary safety end point was freedom from complications (i.e., device- or procedure-related serious adverse events) at 90 days. The first primary performance end point was a combination of adequate atrial capture threshold and sensing amplitude at 3 months. The second primary performance end point was at least 70% atrioventricular synchrony at 3 months while the patient was sitting.
RESULTS RESULTS
Among the 300 patients enrolled, 190 (63.3%) had sinus-node dysfunction and 100 (33.3%) had atrioventricular block as the primary pacing indication. The implantation procedure was successful (i.e., two functioning leadless pacemakers were implanted and had established implant-to-implant communication) in 295 patients (98.3%). A total of 35 device- or procedure-related serious adverse events occurred in 29 patients. The primary safety end point was met in 271 patients (90.3%; 95% confidence interval [CI], 87.0 to 93.7), which exceeded the performance goal of 78% (P<0.001). The first primary performance end point was met in 90.2% of the patients (95% CI, 86.8 to 93.6), which exceeded the performance goal of 82.5% (P<0.001). The mean (±SD) atrial capture threshold was 0.82±0.70 V, and the mean P-wave amplitude was 3.58±1.88 mV. Of the 21 patients (7%) with a P-wave amplitude of less than 1.0 mV, none required device revision for inadequate sensing. At least 70% atrioventricular synchrony was achieved in 97.3% of the patients (95% CI, 95.4 to 99.3), which exceeded the performance goal of 83% (P<0.001).
CONCLUSIONS CONCLUSIONS
The dual-chamber leadless pacemaker system met the primary safety end point and provided atrial pacing and reliable atrioventricular synchrony for 3 months after implantation. (Funded by Abbott Medical; Aveir DR i2i ClinicalTrials.gov number, NCT05252702.).

Identifiants

DOI: 10.1056/NEJMoa2300080 PMID: 37212442
pubmed: 37212442
doi: 10.1056/NEJMoa2300080
doi:

Banques de données

ClinicalTrials.gov
['NCT05252702']

Types de publication

Clinical Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

2360-2370

Investigateurs

Usman Siddiqui (U)
Monica Lo (M)
Devi Nair (D)
Kevin Rist (K)
Mohammad E Mortada (ME)
Gery Tomassoni (G)
Venkata Sagi (V)
Robert Percell (R)
Joseph Levine (J)
D Kirby (D)
Jamie Kim (J)
Michael Shehata (M)
Ramin Davoudi (R)
Pramod Deshmukh (P)
Anand Shah (A)
Eathar Razak (E)
John Summers (J)
Rahul Doshi (R)
Mayer Rashtian (M)
Mohit Chawla (M)
Mark Mascarenhas (M)
Nigel Gupta (N)
Dhanunjaya Lakkireddy (D)
Matthew Bernabei (M)
Paul Friedman (P)
Ramesh Hariharan (R)
Srinivas Dukkipati (S)
Kenneth Plunkitt (K)
James E Ip (JE)
Larry Chinitz (L)
Elaine Wan (E)
Laurence Epstein (L)
Jaret Tyler (J)
Coty Jewell (C)
Sammy Khatib (S)
Shephal Doshi (S)
Kent Nilsson (K)
Chinmay Patel (C)
Mark Shen (M)
Rajesh Banker (R)
Christian Machado (C)
Brian Kim (B)
Darren Jones (D)
Parikshit Sharma (P)
Christopher Stanton (C)
Dilip Mathew (D)
Sri Sundaram (S)
Javier Roman-Gonzalez (J)
John Ip (J)
Robert Canby (R)
Daniel J Cantillon (DJ)
Miguel Valderrabano (M)
Ulrika Birgersdotter-Green (U)
Sandeep Jain (S)
T Jared Bunch (TJ)
Andrew Zadeh (A)
Travis Richardson (T)
Prashant Bhave (P)
Zayd Eldadah (Z)
Blandine Mondesert (B)
Derek Exner (D)
Frederic Paulin (F)
Ratika Parkash (R)
Bernice Tsang (B)
Reinoud Knops (R)
Giulio Zucchelli (G)
Pascal Defaye (P)
Claudio Tondo (C)
Gerhard Hindricks (G)
Jean-Claude Deharo (JC)
Joaquin Fernandez Concha (J)
Lluis Mont (L)
Tim Betts (T)
Clemens Steinwender (C)
Johannes Sperzel (J)
Petr Neuzil (P)
Tom Wong (T)
Christophe Garweg (C)
Chin Pang Chan (CP)
Hung Fat Tse (HF)
Kenji Ando (K)
Hiroshi Tasaka (H)
Kengo Kusano (K)
Junichi Yamaguchi (J)
Lian-Yu Lin (LY)
Reinoud E Knops (RE)
Vivek Y Reddy (VY)
Derek V Exner (DV)
Maria Grazia Bongiorni (M)
Morio Shoda (M)
Joshua M Cooper (JM)
Stephen Fahrig (S)
Raul Weiss (R)
James D Allred (JD)
Judith Mackall (J)
Bruce C Stouch (BC)

Commentaires et corrections

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Informations de copyright

Copyright © 2023 Massachusetts Medical Society.

Auteurs

Reinoud E Knops (RE)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Vivek Y Reddy (VY)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

James E Ip (JE)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Rahul Doshi (R)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Derek V Exner (DV)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Pascal Defaye (P)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Robert Canby (R)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Maria Grazia Bongiorni (MG)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Morio Shoda (M)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Gerhard Hindricks (G)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Petr Neužil (P)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Mayer Rashtian (M)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Karel T N Breeman (KTN)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Jordan R Nevo (JR)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Leonard Ganz (L)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Chris Hubbard (C)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

Daniel J Cantillon (DJ)

From Amsterdam University Medical Centers, Amsterdam (R.E.K., K.T.N.B.); Icahn School of Medicine at Mount Sinai (V.Y.R.) and Weill Cornell Medicine-New York Presbyterian Hospital (J.E.I.) - both in New York; HonorHealth Cardiac Arrhythmia Group, Scottsdale, AZ (R.D.); Foothills Medical Centre, Calgary, AB, Canada (D.V.E.); Centre Hospitalier Régional Universitaire Albert Michallon, Grenoble, France (P.D.); Texas Cardiac Arrhythmia Institute, Austin (R.C.); Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (M.G.B.); Tokyo Women's Medical University, Tokyo (M.S.); Deutsches Herzzentrum der Charité, Berlin (G.H.); Na Homolce Hospital, Prague, Czech Republic (V.Y.R., P.N.); Huntington Memorial Hospital, Pasadena (M.R.), and Abbott Medical, Sylmar (J.R.N., L.G., C.H.) - both in California; and the Cleveland Clinic, Cleveland (D.J.C.).

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Bloc cardiaque › Bloc atrioventriculaire › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › Thérapeutique › Entraînement électrosystolique › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › Équipement et fournitures › Équipement et fournitures électriques › Électrodes › Pacemaker › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › A Dual-Chamber Leadless Pacemaker.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › A Dual-Chamber Leadless Pacemaker.