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Mit der Einf\u00fchrung des ersten sondenlosen atrialen Herzschrittmachers wurden neue Perspektiven in der Antibradykardietherapie er\u00f6ffnet. Dieses Ger\u00e4t erm\u00f6glicht eine sondenlose atriale Stimulation und eine elektrische atriale Wahrnehmung mit dem Potenzial, Komplikationen der Herzschrittmachertherapie deutlich zu verringern. Der sondenlose Vorhofschrittmacher wird \u00fcber die Femoralvene katheterbasiert an der Basis des rechten Vorhofohrs implantiert. In Kombination mit einem ventrikul\u00e4ren sondenlosen Schrittmacher entsteht durch eine galvanisch gekoppelte intrakorporale Kommunikation ein vollwertiges Zweikammer-Herzschrittmachersystem. Dieses kann als Upgrade nach bereits implantiertem ventrikul\u00e4ren oder atrialen sondenlosen Herzschrittmacher erstellt oder direkt (de novo) implantiert werden. Die M\u00f6glichkeit des Upgrades erlaubt dabei eine flexible, an die individuelle Progression der jeweiligen Grunderkrankung angepasste Therapie. Aktuelle Limitationen der breiten klinischen Anwendung sind neben wirtschaftlichen \u00dcberlegungen eine eingeschr\u00e4nkte Batterielaufzeit und Unklarheit bez\u00fcglich Extrahierbarkeit bei Batterieverbrauch.<\/jats:p>","DOI":"10.1007\/s00059-025-05337-7","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T09:25:21Z","timestamp":1758014721000},"page":"407-416","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sondenloser Vorhofschrittmacher","Leadless atrial pacemaker"],"prefix":"10.1007","volume":"50","author":[{"given":"Elia","family":"von Felten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Breitenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Hofer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"5337_CR1","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/0002-9610(83)90130-7","volume":"145","author":"\u00c4 Senning","year":"1983","unstructured":"Senning \u00c4 (1983) Cardiac pacing in retrospect. 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