Dual Chamber Leadless Pacemaker

For some cardiac patients, a dual-chamber leadless pacemaker – one without wires – is an ideal option. Traditional pacemakers use wires to send information from the patient’s heart to the pacemaker device, letting it know when to deliver a beat to the heart when it needs one. Though this style of pacemaker works well for most patients, some require a leadless option – and now there’s a comprehensive one available at Cone Health.

With this new offering available, Cone Health remains at the forefront of cardiac treatment in North Carolina.

Groundbreaking New Pacemaker Technology

For years, pacemakers without wires (or “leads”) have existed, but they only addressed one chamber of the heart: the ventricle. For many patients who need a pacemaker, though, the problem typically comes from a different chamber: the atrium, or a problem with communication between these two chambers. In fact, among patients who require a pacemaker, about 80% require dual-chamber pacing.

Now, there’s a leadless pacemaker that goes into the atrium. When it’s inserted along with a leadless pacemaker in the ventricle, the two devices can communicate with each other to ensure the patient’s heart has the right support. Research has shown that the dual-chamber leadless pacemaker achieves enhanced coordination of the heart’s atria and ventricles and reduces lead-related complication risks, which comprise nearly all the long-term risks seen in traditional pacemakers.

Ideal Candidates for the Dual-Chamber Leadless Pacemaker

This dual-chamber leadless pacemaker system is something providers can recommend to patients:

• who require dual-chamber pacing to treat their condition
• who don’t have a pathway available for the leads in a traditional pacemaker (such as someone undergoing dialysis or with atypical anatomy)
• who are especially prone to developing infections
• who have memory issues, including dementia, because these patients can have a hard time adhering to post-procedural restrictions from a traditional pacemaker
• who are younger, more active and more likely to disrupt the leads in a typical pacemaker

What to Expect During the Procedure

Dr. Augustus Mealor, MD, has been inserting dual chamber leadless pacemakers at Cone Health since early 2025. He says another big difference between the dual leadless pacemaker and a traditional pacemaker is that the newer device involves a much more involved procedure to insert.

“With a traditional pacemaker, a patient is under conscious sedation, and the pacemaker is inserted below the collarbone,” he said. “The whole procedure takes about 40 minutes.”

But with the new dual chamber leadless pacemaker, he says, the procedure can be quite a bit longer since two devices need to be placed. The patient is more sedated – under general anesthesia – and the devices are inserted through a vein at the top of the leg. The pacemakers then attach directly to the muscular wall inside the heart. While a more involved procedure, it is still minimally invasive, with reduced pain and recovery times.

Ask your doctor if a dual chamber leadless pacemaker may be a good solution for the heart condition you may be facing. If so, your doctor can refer you to the cardiologists at Cone Health Heart & Vascular.