Leadless pacemakers: A review of communication methods, energy management, and clinical applications-ZENTIME PUBLISHING CORPORATION LIMITED

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Leadless pacemakers: A review of communication methods, energy management, and clinical applications

Yundi Zhao^1,2, Liping Du², Wei Chen², Ping Guo², Chunsheng Wu^1,2

¹College of Future Technology, Xi'an Jiaotong University, Xi'an 710100, Shaanxi Province, China. ²Institute of Med ical Engineering, Department of Biophysics, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.

Address correspondence to: Chunsheng Wu, Institute of Medical Engineering, Department of Bio physics, School of Basic Medical Sciences, Xi'an Jiaotong University, 76 Yanta West Road, Yanta Cam pus, Xi'an 710061, Shaanxi Province, China. E-mail: wuchunsheng@xjtu.edu.cn.

Acknowledgement: This work was supported by National Key Research and Development Program of China, the Ministry of Science and Technology, People's Republic of China (2023YFC2411902).

DOI:https://doi.org/10.61189/417936cenngx.

Received March 12, 2025; Accepted June 18, 2025; Published September 30, 2025.

Highlights

● This review explores advancements in leadless pacemaker technology, focusing on optimized wireless communication, energy-efficient strategies, and artificial intelligence-enhanced clinical applications.

● As a minimally invasive innovation, these devices enhance patient outcomes through adaptive algorithms and secure data transmission. Key developments include load modulation to maintain signal integrity and intelligent remote monitoring for real-time diagnostics.

● The review also addresses cybersecurity challenges and underscores the transformative potential of integrated intelligent systems in revolutionizing cardiac therapeutics.

Abstract

Leadless pacemakers have emerged as a mainstream clinical solution, and their communication capabilities, crucial for reliable pacing and device monitoring, continue to evolve. This review systematically examines the fundamental principles of leadless pacemaker communication systems, current design requirements, existing challenges, and future development trends. We outline the bidirectional communication mechanism between leadless pacemakers and external programmers through wireless technologies, focusing on radio-frequency field communication coupled with load modulation techniques to optimize energy efficiency and transmission reliability. Additionally, we analyze the role of artificial intelligence in adaptive communication protocols and explore the clini cal potential of remote monitoring and control systems. This comprehensive analysis aims to serve as a reference for the development of communication architectures for leadless pacemakers.

Keywords: Pacemaker, leadless, wireless communication, radio frequency field, programming, remote control

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