Rationale For and Use of Lumenless Pacing Leads

Introduction: Most currently available pacing and defibrillation leads utilize a stylet-based design that facilitates implantation. This has advantages, but also increases the lead diameter and adds the potential for metal fatigued-based conductor failure. Methods A systematic literature search was conducted, and the authors add their twenty-year experience with this lead design. Results The global experience with lumenless leads was reviewed both for “standard” positioning and with conduction system pacing. Methods for both placement and system modification are reviewed. Conclusions Lumenless leads have the potential to improve the durability of endocardial pacing and facilitate conduction system pacing.