Entirely self-contained cardiac pacing systems for direct implantation within the heart via deflectable catheter are now available for use in humans. Worldwide, there have been more 7000 implants of the “transcatheter” or “leadless” pacemaker.∗ The concept of these pacing systems is far from new; Spickler et al.1 were able to achieve cardiac pacing in animals using a capsular nuclear-powered system in 1970. However, only recently has technology enabled sufficient miniaturization to make transcatheter pacing feasible.