კარდიოსტიმულაციის თანამედროვე ტექნოლოგიები: ტრანსვენური და leadless სისტემები და ენერგიის უსადენო გადაცემის პერსპექტივები

Giorgi Karabaki; Vladimer Kharabadze; Solomon Zeikidze; Ia Khakhutaishvili

doi:10.52340/spectri.2025.12.02.13

Authors

Giorgi Karabaki შპს თბილისის გულისა და სისხლძარღვთა კლინიკა, თბილისი, საქართველო
Vladimer Kharabadze შპს თბილისის გულისა და სისხლძარღვთა კლინიკა, თბილისი, საქართველო
Solomon Zeikidze David Aghmashenebeli University of Georgia (Ltd)
Ia Khakhutaishvili Ivane Javakishvili Tbilisi State University, Tbilisi, Georgia

DOI:

https://doi.org/10.52340/spectri.2025.12.02.13

Keywords:

cardiac pacing, leadless pacemaker, transvenous lead, wireless power transfer, implantable devices, bradyarrhythmia

Abstract

Background and aim. Cardiac pacing has evolved from conventional transvenous (lead-based) systems to fully intracardiac leadless devices. Transvenous systems are reliable and versatile, but their main drawback is complications related to the lead and the subcutaneous device pocket. Leadless systems removed both components, yet introduced a new constraint: because the device is small, its battery capacity is limited. This article reviews established and emerging pacing technologies using quantitative data and discusses an approach in which the energy source and the intracardiac stimulating component are physically separated.

Methods. A narrative literature review was performed in PubMed and IEEE Xplore for 2005–2025, covering clinical trials, large registries, international guidelines and peer-reviewed engineering papers.

Results. Early complication rates of transvenous systems range from 4.8% to 12.4%, and most late complications are lead-related [3]. With leadless systems, major complications at 36 months are almost halved (4.1% vs 8.5%) [19]; in a large population, chronic complications were 32% lower and reinterventions 41% lower [15]. At the same time, leadless implantation carries its own, mainly procedural risks (e.g. pericardial effusion 0.4–1.5%) [6,8]. In the dual-chamber system, atrioventricular synchrony was achieved in 97.3% of patients [13].

Conclusion. Technological progress aims to reduce lead-related complications, miniaturise devices and expand functionality. Separating the energy source from the stimulating component is one possible way to overcome the battery limitation of leadless systems, although its clinical value has not yet been established.

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Author Biographies

Giorgi Karabaki, შპს თბილისის გულისა და სისხლძარღვთა კლინიკა, თბილისი, საქართველო

MD

Vladimer Kharabadze, შპს თბილისის გულისა და სისხლძარღვთა კლინიკა, თბილისი, საქართველო

MD

Solomon Zeikidze, David Aghmashenebeli University of Georgia (Ltd)

MD, PhD

Ia Khakhutaishvili, Ivane Javakishvili Tbilisi State University, Tbilisi, Georgia

MD, PhD

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