[1]张能 邢强 汤宝鹏.无导线起搏器植入术后阈值变化的研究进展[J].心血管病学进展,2025,(2):97.[doi:10.16806/j.cnki.issn.1004-3934.2025.02.001]
 ZHANG Neng,XING Qiang,TANG Baopeng.Threshold Changes after Leadless Pacemaker Implantation[J].Advances in Cardiovascular Diseases,2025,(2):97.[doi:10.16806/j.cnki.issn.1004-3934.2025.02.001]
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无导线起搏器植入术后阈值变化的研究进展()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年2期
页码:
97
栏目:
综述
出版日期:
2025-02-25

文章信息/Info

Title:
Threshold Changes after Leadless Pacemaker Implantation
作者:
张能 邢强 汤宝鹏
(新疆医科大学第一附属医院心脏中心起搏电生理科,新疆 乌鲁木齐 830054)
Author(s):
ZHANG NengXING QiangTANG Baopeng
( Department of Cardiac Pacing and Electrophysiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China )
关键词:
无导线起搏器起搏阈值心脏延迟钆增强核磁显像炎症心肌纤维化
Keywords:
Leadless pacemakerPacing thresholdLate gadolinium enhanced cardiac magnetic resonance imagingInflammationMyocardial fibrosis
DOI:
10.16806/j.cnki.issn.1004-3934.2025.02.001
摘要:
无导线起搏器植入术后阈值升高会缩短起搏器寿命或使设备无法运行。文献表明,固定牢靠是获得良好阈值的前提条件,炎症和纤维化可能是无导线起搏器植入术后阈值升高的原因。心脏延迟钆增强核磁显像是定量和定性心肌瘢痕和纤维化的非侵入性金标准,研究显示使用心脏延迟钆增强核磁显像可以改善心脏再同步化治疗的临床效果。心脏延迟钆增强核磁显像有望与无导线起搏器植入过程相结合,指导无导线起搏器植入最佳部位,避免植于瘢痕及纤维化心肌区域,以获得良好电学参数,以期达到满意的临床效果。
Abstract:
Elevated threshold after leadless pacemaker implantation can shorten the lifespan of the pacemaker or render the device inoperable. The studies suggest ed that secure fixation is the prerequisite for obtaining the good threshold ,while inflammation and fibrosis may be the causes of elevated threshold after leadless pacemaker implantation. Late gadolinium enhanced cardiac magnetic resonance imaging is the non-invasive gold standard for quantitative and qualitative assessment of myocardial scars and fibrosis. Studies have shown that the use of Late gadolinium enhanced cardiac magnetic resonance imaging can improve the clinical efficacy of cardiac resynchronization therapy. Late gadolinium enhanced cardiac magnetic resonance imaging is expected to be combined with the implantation process of leadless pacemakers to guide the optimal implantation site,avoid implantation in scar and fibrotic myocardial areas,and obtain good electrical parameters,achieving satisfactory clinical outcomes

参考文献/References:

[1].Duray GZ,Ritter P,El-Chami M,et al. Long-term performance of a transcatheter pacing system:12-month results from the Micra Transcatheter Pacing Study[J]. Heart Rhythm,2017,14(5):702-709.
[2].Eggen MD,Grubac V,Bonner MD. Design and evaluation of a novel fixation mechanism for a transcatheter pacemaker[J].?IEEE Trans Biomed Eng,2015,62(9):2316-2323.
[3].Piccini JP,Stromberg K,Jackson KP,et al. Long-term outcomes in leadless Micra transcatheter pacemakers with elevated thresholds at implantation:results from the Micra Transcatheter Pacing System Global Clinical Trial[J]. Heart Rhythm,2017,14(5):685-691.
[4].Tam MTK,Cheng YW,Chan JYS,et al. Aveir VR real-world performance and chronic pacing threshold prediction using mapping and fixation electrical data[J].?Europace,2024,26(3):euae051.
[5].Reynolds DW,Ritter P. A leadless intracardiac transcatheter pacing system[J]. N Engl J Med,2016,374(26):2604-2605.
[6].Tjong FV,Reddy VY. Permanent leadless cardiac pacemaker therapy:a comprehensive review[J]. Circulation,2017,135(15):1458-1470.
[7].Lenormand T,Abou Khalil K,Bodin A,et al. Leadless cardiac pacing:results from a large single-centre experience[J].?Arch Cardiovasc Dis,2023,116(6-7):316-323.
[8].Oliveira VMR,Rivera A,Oliveira IC,et al. The effectiveness and safety of leadless pacemakers:an updated meta-analysis[J].?Curr Cardiol Rep,2024,26(8):789-799.
[9].Tolosana JM,Guasch E,San Antonio R,et al. Very high pacing thresholds during long-term follow-up predicted by a combination of implant pacing threshold and impedance in leadless transcatheter pacemakers[J]. J Cardiovasc Electrophysiol,2020,31(4):868-874.
[10].Higuchi M,Shinoda Y,Hasegawa T,et al. Predictors of increase in pacing threshold after transcatheter pacing system implantation due to micro-dislodgement[J]. Pacing Clin Electrophysiol,2020,43(11):1351-1357.
[11].Saxonhouse SJ,Conti JB,Curtis AB. Current of injury predicts adequate active lead fixation in permanent pacemaker/defibrillation leads[J]. J Am Coll Cardiol,2005,45(3):412-417.
[12].Redfearn DP,Gula LJ,Krahn AD,et al. Current of injury predicts acute performance of catheter-delivered active fixation pacing leads[J].?Pacing Clin Electrophysiol,2007,30(12):1438-1444.
[13].Yoh M,Takagi M,Takahashi H,et al. The unstable pacing thresholds of the leadless transcatheter pacemaker affected by body positions in subacute phase after implant[J]. Eur Heart J Case Rep,2018,3(1):yty160.
[14].Mond HG,Helland JR,Stokes K,et al. The electrode-tissue interface:the revolutionary role of steroid-elution[J].?Pacing Clin Electrophysiol,2014,37(9):1232-1249.
[15].Kistler PM,Liew G,Mond HG. Long-term performance of active-fixation pacing leads:a prospective study[J].?Pacing Clin Electrophysiol,2006,29(3):226-230.
[16].Kiani S,Wallace K,Stromberg K,et al. A predictive model for the long-term electrical performance of a leadless transcatheter pacemaker[J].?JACC Clin Electrophysiol,2021,7(4):502-512.
[17].Karpawich PP,Hakimi M,Arciniegas E,et al. Improved chronic epicardial pacing in children:steroid contribution to porous platinized electrodes[J].?Pacing Clin Electrophysiol,1992,15(8):1151-1157.
[18].Kutyifa V,Zima E,Molnar L,et al. Direct comparison of steroid and non-steroid eluting small surface pacing leads:randomized,multicenter clinical trial[J].?Cardiol J,2013,20(4):431-438.
[19].Huang TY,Baba N. Cardiac pathology of transvenous pacemakers[J].?Am Heart J,1972,83(4):469-474.
[20].Keiler J,Schulze M,Dreger R,et al. Quantitative and qualitative assessment of adhesive thrombo-fibrotic lead encapsulations (TFLE) of pacemaker and ICD leads in arrhythmia patients-a?post mortem?study[J].?Front Cardiovasc Med,2020,7:602179.
[21].Yang Z,Kirchhof N,Li S,et al. Effect of steroid elution on electrical performance and tissue responses in quadripolar left ventricular cardiac vein leads [J].?Pacing Clin Electrophysiol,2015,38(8):966-972.
[22].Kistler PM,Kalman JM,Fynn SP,et al. Rapid decline in acute stimulation thresholds with steroid-eluting active-fixation pacing leads[J].?Pacing Clin Electrophysiol,2005,28(9):903-909.
[23].Holtackers RJ,Emrich T,Botnar RM,et al. Late gadolinium enhancement cardiac magnetic resonance imaging:from basic concepts to emerging methods[J].?Rofo,2022,194(5):491-504.
[24].Jada L,Holtackers RJ,Martens B,et al. Quantification of myocardial scar of different etiology using dark- and bright-blood late gadolinium enhancement cardiovascular magnetic resonance[J].?Sci Rep,2024,14(1):5395.
[25].Holtackers RJ,van de Heyning CM,Chiribiri A,et al. Dark-blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of subendocardial scar:a review of current techniques[J].?J Cardiovasc Magn Reson,2021,23(1):96.
[26].Meier C,Eisenbl?tter M,Gielen S. Myocardial late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (CMR)—An important risk marker for cardiac disease[J].?J Cardiovasc Dev Dis,2024,11(2):40.
[27].Degtiarova G,Claus P,Duchenne J,et al. Left ventricular regional glucose metabolism in combination with septal scar extent identifies CRT responders[J]. Eur J Nucl Med Mol Imaging,2021,48(8):2437-2446.
[28].Fieno DS,Kim RJ,Chen EL,et al. Contrast-enhanced magnetic resonance imaging of myocardium at risk:distinction between reversible and irreversible injury throughout infarct healing[J]. J Am Coll Cardiol,2000,36(6):1985-1991.
[29].Moon JC,Reed E,Sheppard MN,et al. The histologic basis of late gadolinium enhancement cardiovascular magnetic resonance in hypertrophic cardiomyopathy[J]. J Am Coll Cardiol,2004,43(12):2260-2264.
[30].Rehwald WG,Fieno DS,Chen EL,et al. Myocardial magnetic resonance imaging contrast agent concentrations after reversible and irreversible ischemic injury[J]. Circulation,2002,105(2):224-229.
[31].Alachkar MN,Mischke T,Mahnkopf C. [Cardiac magnetic resonance imaging and the myocardium:differentiation between vital and nonvital tissue][J].?Herzschrittmacherther Elektrophysiol,2022,33(3):272-277.
[32].Bazoukis G,Hui JMH,Lee YHA,et al. The role of cardiac magnetic resonance in identifying appropriate candidates for cardiac resynchronization therapy—A systematic review of the literature[J].?Heart Fail Rev,2022,27(6):2095-2118.
[33].Hu X,Xu H,Hassea SRA,et al. Comparative efficacy of image-guided techniques in cardiac resynchronization therapy:a meta-analysis[J].?BMC Cardiovasc Disord,2021,21(1):255.
[34].Larsen CK,Smiseth OA,Duchenne J,et al. Cardiac Magnetic Resonance Identifies Responders to Cardiac Resynchronization Therapy with an Assessment of Septal Scar and Left Ventricular Dyssynchrony[J].?J Clin Med,2023,12(22):7182.
[35].Behar JM,Jackson T,Hyde E,et al. Optimized left ventricular endocardial stimulation is superior to optimized epicardial stimulation in ischemic patients with poor response to cardiac resynchronization therapy:a combined magnetic resonance imaging,electroanatomic contact mapping,and hemodynamic study to target endocardial lead placement[J]. JACC Clin Electrophysiol,2016,2(7):799-809.
[36].Shetty AK,Duckett SG,Ginks MR,et al. Cardiac magnetic resonance-derived anatomy,scar,and dyssynchrony fused with fluoroscopy to guide LV lead placement in cardiac resynchronization therapy:a comparison with acute haemodynamic measures and echocardiographic reverse remodelling[J]. Eur Heart J Cardiovasc Imaging,2013,14(7):692-699.
[37].Leyva F,Foley PW,Chalil S,et al. Cardiac resynchronization therapy guided by late gadolinium-enhancement cardiovascular magnetic resonance[J]. J Cardiovasc Magn Reson,2011,13(1):29.
[38].Liu Z,Hu Y,Qu X,et al. A self-powered intracardiac pacemaker in swine model[J].?Nat Commun,2024,15(1):507.

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更新日期/Last Update: 2025-03-11