Chancen und Grenzen Device-basierter Rhythmustherapie

Device-based rhythm therapy has revolutionized the landscape of cardiology and enabled innovative progress in the treatment of heart rhythm disorders. From cardiac pacemakers to implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) devices, these technologies have decisively enhanced the lives of millions of patients worldwide; however, despite their broad applicability from atrioventricular (AV) blocks up to life-threatening ventricular arrhythmia and the practically indispensable role in the clinical practice, there is still a focus on important challenges. A crucial concern is the limited battery life of rhythm therapy devices, as the replacement of exhausted batteries usually necessitates a renewed surgical intervention. Electrode problems, such as detachment or breakage, compromise functionality and often require revision interventions. Furthermore, the current technologies, including pacemakers, ICD and CRT devices, often have a limited adaptability to individual patient needs. The integration of telemedicine and remote monitoring into rhythm therapy devices poses a further challenge, particularly in the context of cybersecurity and the transmission of highly sensitive medical data. Despite these challenges, technological advances have shown promising solution approaches. Subcutaneous and extravascular ICDs reduce risks, wireless pacemaker systems provide alternative implantation options and physiological pacing, such as His bundle stimulation and left bundle branch pacing, optimizes resynchronization therapy. Overall, device-based rhythm therapy remains a fascinating field with significant potential that can be further developed by continuous innovation and interdisciplinary collaboration. Despite the current limitations, technological advances show very promising ways in which the therapy can be refined and individualized to more effectively fulfil the needs of patients.