Leadless cardiac pacemakers (L-PM) are miniaturized, fully implantable devices designed to avoid complications of conventional pacemakers.

For single-chamber L-PMs for right ventricular pacing (VR), one randomised controlled trial (RCT) and seven cohort studies indicate an added benefit. However, this evidence is limited to less robust cohort studies. For AV-synchronous L-PMs (atrioventricular-synchronous L-PMs), evidence suggests potentially higher safety but possibly lower effectiveness. The evidence for dual-chamber leadless pacemakers and atrial L-PMs is currently insufficient due to a lack of comparative studies. Re-evaluation is recommended for 2028, as new RCT results are expected by the end of 2027.