Pacing and Defibrillation Without Leads

Guest: Nicholas Tan, M.D. Host: Anthony Kashou, M.D. In this episode, listeners will hear about the history of pacemakers and defibrillators, both with and without leads. Potential risks and complications associated with transvenous cardiac devices are discussed. The listener should gain an awareness of leadless pacing and extravascular defibrillator systems. Topics Discussed: • What are some of the risks associated with transvenous device implants? • What is leadless pacing, and how is it generally performed? • How does a defibrillator without transvenous leads work? • When will you consider “transvenous-free” pacing or defibrillation systems? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on X @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Recorded on: 09-December-2025 00:00 Introduction and series overview (Dr. Sharonne Hayes) 03:10 Who’s a candidate for a leadless pacemaker? (key indications) 06:47 Subcutaneous ICD basics: how it’s placed and what it does/doesn’t do 10:23 Biggest drawback: sensing issues and inappropriate shocks