[1]刘晨 牛国栋 郭涛 付明鹏 乔宇 郭雨龙.无导线起搏器单中心临床应用研究[J].心血管病学进展,2025,(1):93.[doi:10.16806/j.cnki.issn.1004-3934.2025.01.019]
 LIU Chen,NIU Guodong,GUO Tao,et al.Clinical Application of Leadless Pacemakers in Single Center[J].Advances in Cardiovascular Diseases,2025,(1):93.[doi:10.16806/j.cnki.issn.1004-3934.2025.01.019]
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无导线起搏器单中心临床应用研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年1期
页码:
93
栏目:
论著
出版日期:
2025-01-25

文章信息/Info

Title:
Clinical Application of Leadless Pacemakers in Single Center
作者:
刘晨 牛国栋 郭涛 付明鹏 乔宇 郭雨龙
(云南省阜外心血管病医院/昆明医科大学附属心血管病医院,云南 昆明 650032)
Author(s):
LIU ChenNIU GuodongGUO TaoFU MingpengQIAO YuGUO Yulong
(Fuwai Yunnan Cardiovascular Hospital/Affiliated Cardiovascular Hospital of Kunming Medical University,Kunming 650032,Yunnan,China)
关键词:
无导线起搏器安全性有效性
Keywords:
Leadless pacemakerSafetyEfficacy
DOI:
10.16806/j.cnki.issn.1004-3934.2025.01.019
摘要:
目的 对单中心无导线起搏器患者的临床资料、植入及随访情况进行分析,探讨其安全性和有效性。方法 入组2020年1月 —2023年12月于云南省阜外心血管病医院行无导线起搏器植入的患者,单组研究,记录临床资料、手术情况、并发症、术后起搏参数变化等数据,分析其安全性及有效性。结果 共纳入44例无导线起搏器植入患者,平均年龄(77.7±9.8)岁,男性22例,心房颤动或心房扑动伴长R-R间期9例、房室传导阻滞20例、病态窦房结综合征18例。术后有2例出现动静脉瘘(均<3 mm),1例假性动脉瘤,3例下肢静脉血栓;有1例行3.0 T磁共振检查,无不适症状,无心脏穿孔、心包积液、感染、起搏器脱落、伤口破溃。术后随访1~34个月,R波振幅升高、阈值稳定、阻抗逐渐降低。结论 本中心研究结果显示无导线起搏器安全可行,适用范围广,手术时间短,成功率高,术后参数稳定,并发症少,临床效果满意。
Abstract:
Objective To analyze the clinical data,implantation,and follow-up of patients with leadless pacemakers at a single center,and explore their safety and e fficacy. Methods A single group study was conducted on patients who underwent leadless pacemaker implantation at Fuwai Yunnan Cardiovascular Hospital from January 2020 to December 2023. Clinical data,surgical conditions,complications,and chan ges in postoperative pacing parameters were recorded to analyze their safety and effectiveness. Results A total of 44 patients with leadless pacemaker implantation were included,with an average age of (77.7 ± 9.8) years,including 22 males. There were 9 cases of atrial fibrillation or atrial flutter with long R-R interval,20 cases of atrioventricular block,and 18 cases of sick sinus syndrome. There were 2 cases of arteriovenous fistula(both <3 mm),1 case of pseudoaneurysm,and 3 cases of lower limb venous thrombosis after surgery. One patient had a 3.0 T magnetic resonance imaging with no discomfort symptoms,no cardiac perforation,pericardial effusion,infection,pacemaker detachment,or wound rupture. One year follow-up after surgery showed an increase in R-wave amplitude,a stable threshold,and a gradual decrease in impedance. Conclusion The research results of our center show that leadless pacemakers are safe and feasible,with a wide range of applications,short surgical time,high success rate,stable postoperative parameters,few complications,and satisfactory clinical outcomes

参考文献/References:

[1]Lau CP,Lee KL. Transcatheter leadless cardiac pacing in renal failure with limited venous access[J]. Pacing Clin Electrophysiol,2016,39(11):1281-1284.

[2] El-Chami MF,Soejima K,Piccini JP, et al. Incidence and outcomes of systemic infections in patients with leadless pacemakers:data from the Micra IDE study[J]. Pacing Clin Electrophysiol,2019,42(8):1105-1110.

[3]汤宝鹏,张澍,黄德嘉.无导线心脏起搏器未来可期[J].中华心律失常学杂志,2021,25(1):5-9.

[4]Kusumoto FM,Schoenfeld MH,Barrett C,et al. 2018 ACC/ AHA/ HRS Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay:a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society[J]. Circulation,2019,140(8):e382-e482.

[5]Udo EO,Zuithoff NP,van Hemel NM,et al. Incidence and predictors of short- and long-term complications in pacemaker therapy:the FOLLOWPACE study[J]. Heart Rhythm,2012,9(5):728-735.

[6] Senaratne JM,Wijesundera J,Chhetri U,et al. Reduced incidence of CIED infections with peri- and post-operative antibiotic use in CRT-P/D and ICD procedures[J]. Medicine(Baltimore),2022,101(40):e30944.

[7] Lisy M,Schmid E,Kalender G,et al. Coronary sinus lead extraction in CRT patients with CIED-related infection:risks,implications and outcomes[J]. Minerva Cardioangiol,2015,63(2):91-98.

[8] El-Chami MF,Al-Samadi F,Clementy N,et al. Updated performance of the Micra transcatheter pacemaker in the real world setting:a comparison to the investigational study and a transvenous historical control[J]. Heart Rhythm,2018,15(12):1800-1807.

[9]Roberts PR,Clementy N,Al Samadi F,et al. A leadless pacemaker in the real-world setting:The Micra Transcatheter Pacing System Post-Approval Registry[J]. Heart Rhythm,2017,14(9):1375-1379.

[10]El-Chami MF,Bockstedt L,Longacre C,et al. Leadless vs. transvenous single-chamber ventricular pacing in the Micra CED study:2-year follow-up[J]. Eur Heart J,2022,43(12):1207-1215.

[11]Crossley GH,Piccini JP,Longacre C,et al. Leadless versus transvenous single-chamber ventricular pacemakers:3 year follow-up of the Micra CED Study[J]. J Cardiovasc Electrophysiol,2023,34(4):1015-1023.

[12]El-Chami?MF,Johansen?JB,Zaidi?A,et al. Leadless pacemaker implant in patients with pre-existing infections:results from the Micra postapproval registry[J]. J Cardiovasc Electrophysiol,2019,30(4):569-574.

[13]El-Chami MF,Garweg C,Clementy N,et al. Leadless pacemakers at 5-year follow-up:the Micra transcatheter pacing system post-approval registry[J]. Eur Heart J ,2024,45(14):1241-1251.

[14]Reddy VY,Exner DV,Cantillon DJ,et al. Percutaneous implantation of an entirely intracardiac leadless pacemaker [J]. N Engl J Med,2015,373(12):1125-1135.

[15]李玉秋,陈柯萍,戴研,等.无导线起搏器在真实世界中的临床应用:3年随访结果分析[J].中华心律失常学杂志,2019,23(2):120-123.

[16]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.

[17]Mitacchione G,Schiavone M,Gasperetti A,et al. Micra-AV leadless pacemaker and atrioventricular (dys) synchrony:a stepwise process[J]. Pacing Clin Electrophysiol,2021,44(10):1738-1742.

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更新日期/Last Update: 2025-02-26