Combination of a leadless pacemaker and subcutaneous defibrillator: First in-human report

Introduction Although transvenous pacemakers and implantable cardioverter-defibrillators (ICD) have long been the standard of care, they are not without significant drawbacks. In recent years, major advances have been achieved in leadless pacemaker technology and entirely subcutaneous ICD (S-ICD) systems that obviate intracardiac leads and hence carry the potential to reduce associated complications. Unlike standard ICDs, the S-ICD is devoid of antibradycardia pacing capabilities. Nevertheless, certain patients, such as those lacking vascular access for transvenous lead insertion, may benefit from leadless devices with both pacing and ICD functions. Herein, we present the first patient in whom the leadless pacemaker and S-ICD were used in combination.