[1]张昕 刘兴斌.无导线起搏器相关并发症研究进展[J].心血管病学进展,2025,(6):481.[doi:10.16806/j.cnki.issn.1004-3934.2025.06.001]
 ZHANG Xin,LIU Xingbin.Leadless Pacemaker-Related Complications[J].Advances in Cardiovascular Diseases,2025,(6):481.[doi:10.16806/j.cnki.issn.1004-3934.2025.06.001]
点击复制

无导线起搏器相关并发症研究进展()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年6期
页码:
481
栏目:
综述
出版日期:
2025-06-25

文章信息/Info

Title:
Leadless Pacemaker-Related Complications
作者:
张昕 刘兴斌
(四川大学华西医院心内科,成都 610041)
Author(s):
ZHANG XinLIU Xingbin
(Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
关键词:
无导线起搏器传统起搏器并发症
Keywords:
Leadless pacemaker Traditional pacemaker Complications
DOI:
10.16806/j.cnki.issn.1004-3934.2025.06.001
摘要:
无导线起搏器(LP)是一种新兴的心脏植入设备,旨在克服传统经静脉起搏器因导线和囊袋引发的并发症。尽管LP在减少短期和中期经静脉起搏导线相关并发症方面表现出显著优势,但仍面临心包积液、心脏穿孔和设备脱位等潜在并发症的风险。综述LP植入术中及术后相关并发症的最新临床研究,旨在为临床管理和治疗提供指导。
Abstract:
The leadless pacemaker (LP)as an emerging cardiac implantable device,aims to overcome complications associated with traditional transvenous pacemakers,such as lead- and pocket-related issues. While LP have demonstrated significant advantages in reducing short- and mid-term lead-related complications,they still face potential risks,including pericardial effusion,cardiac perforation,and device dislodgement. This review summarizes recent clinical studies on complications associated with LP implantation during and after the procedure,in order to provide guidance for clinical management and treatment

参考文献/References:

[1] Mond HGProclemer A. The 11th world survey of cardiac pacing and implantable cardioverter-defibrillators:calendar year 2009-a World Society of Arrhythmia’s project[J]. Pacing Clin Electrophysiol,2011,34(8):1013-1027.
[2] 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.
[3] Kirkfeldt RE,Johansen JB,Nohr EA,et al. Complications after cardiac implantable electronic device implantations:an analysis of a complete,nationwide cohort in Denmark[J]. Eur Heart J,2014,35(18):1186-1194.
[4] Tarakji KG,Wazni OM,Harb S,et al. Risk factors for 1-year mortality among patients with cardiac implantable electronic device infection undergoing transvenous lead extraction:the impact of the infection type and the presence of vegetation on survival[J]. Europace,2014,16(10):1490-1495.
[5] Ip JE. Advanced helix-fixation leadless cardiac pacemaker implantation techniques to improve success and reduce complications[J]. J Cardiovasc Electrophysiol,2023,34(5):1268-1276.
[6] Darlington D,Brown P,Carvalho V,et al. Efficacy and safety of leadless pacemaker:A systematic review,pooled analysis and meta-analysis[J]. Indian Pacing Electrophysiol J,2022,22(2):77-86.
[7] Vamos M,Erath JW,Benz AP,et al. Incidence of cardiac perforation with conventional and with leadless pacemaker systems:a systematic review and meta-analysis[J]. J Cardiovasc Electrophysiol,2017,28(3):336-346.
[8] Piccini JP,Cunnane R,Steffel J,et al. Development and validation of a risk score for predicting pericardial effusion in patients undergoing leadless pacemaker implantation:experience with the Micra transcatheter pacemaker[J]. Europace,2022,24(7):1119-1126.
[9] Khan M Z,Sattar Y,Alruwaili W,et al. Pericardial effusion requiring intervention in patients undergoing leadless pacemaker implantation:a real-world analysis from the National Inpatient Sample database[J]. Heart Rhythm O2,2024,5(4):217-223.
[10] Tjong FV,Reddy VY. Permanent leadless cardiac pacemaker therapy:a comprehensive review[J]. Circulation,2017,135(15):1458-1470.
[11] Hauser RG,Gornick CC,Abdelhadi RH,et al. Leadless pacemaker perforations:Clinical consequences and related device and user problems[J]. J Cardiovasc Electrophysiol,2022,33(2):154-159.
[12] Fichtner S,Estner HL,Nabauer M,et al. Percutaneous extraction of a leadless Micra pacemaker after dislocation:a case report[J]. Eur Heart J Case Rep,2019,3(3):ytz113.
[13] Arai H,Mizukami A,Hanyu Y,et al. Leadless pacemaker implantation sites confirmed by computed tomography and their parameters and complication rates[J]. Pacing Clin Electrophysiol,2022,45(2):196-203.
[14] Tokavanich N,Machado C,Banga S,et al. Implant efficiency and clinical performance of Aveir VR and Micra VR leadless pacemaker:a multicenter comparative analysis of 67 patients[J]. Pacing Clin Electrophysiol,2023,46(8):827-832.
[15] Kouranloo K,Lawson J,Goode A,et al. Improving outcomes in single chamber leadless pacemakers:strategies for minimizing vascular complications[J]. BMC Cardiovasc Disord,2023,23(1):601.
[16] Reynolds D,Duray GZ,Omar R,et al. A leadless intracardiac transcatheter pacing system[J]. N Engl J Med,2016,374(6):533-541.
[17] Piccini JP,El-Chami M,Wherry K,et al. Contemporaneous comparison of outcomes among patients implanted with a leadless vs transvenous single-chamber ventricular pacemaker[J]. JAMA Cardiol,2021,6(10):1187-1195.
[18] 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.
[19] El-Chami MF,Garweg C,Iacopino S,et al. Leadless pacemaker implant,anticoagulation status,and outcomes:Results from the Micra Transcatheter Pacing System Post-Approval Registry[J]. Heart Rhythm,2022,19(2):228-234.
[20] Loughlin G,Pachon M,Martinez-Sande JL,et al. Outcomes of leadless pacemaker implantation in patients with mechanical heart valves[J]. J Cardiovasc Electrophysiol,2022,33(5):997-1004.
[21] Sterlinski M,Demkow M,Plaskota K,et al. Percutaneous extraction of a leadless Micra pacemaker from the pulmonary artery in a patient with complex congenital heart disease and complete heart block[J]. EuroIntervention,2018,14(2):236-237.
[22] Afzal MR,Daoud EG,Cunnane R,et al. Techniques for successful early retrieval of the Micra transcatheter pacing system:a worldwide experience[J]. Heart Rhythm,2018,15(6):841-846.
[23] 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.
[24] 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.
[25] 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.
[26] Hagiwara H,Morimoto J,Tamura T,et al. Leadless pacemaker with acute but transient elevation of lead impedance and pacing threshold[J]. CJC Open,2023,5(6):412-414.
[27] Sano M,Takahashi N,Kaneko Y,et al. Rate-dependent elevation of the capture threshold after implantation of a leadless pacemaker[J]. Pacing Clin Electrophysiol,2024,47(7):938-940.
[28] Morita J,Kondo Y,Okada T,et al. Predictors of pacing capture threshold exacerbation after leadless pacemaker implantation[J]. Int Heart J,2023,64(4):602-605.
[29] Yoshiyama T,Nakatsuji K,Yanagishita T,et al. A case of repeated rate-dependent pacing threshold elevation after leadless pacemaker implantation[J]. Pacing Clin Electrophysiol,2024,47(10):1391-1393.
[30] 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.
[31] Tolosana JM,Guasch E,San AR,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.
[32] 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.
[33] Sanchez R,Nadkarni A,Buck B,et al. Incidence of pacing-induced cardiomyopathy in pacemaker-dependent patients is lower with leadless pacemakers compared to transvenous pacemakers[J]. J Cardiovasc Electrophysiol,2021,32(2):477-483.
[34] Saeed AK,Martinez A,Prasad RM,et al. Pacing-induced cardiomyopathy in leadless and traditional pacemakers:a single-center retrospective analysis[J]. Cureus,2023,15(7):e41393.
[35] Reddy VY,Exner DV,Doshi R,et al. Primary results on safety and efficacy from the LEADLESS Ⅱ-Phase 2 worldwide clinical trial[J]. JACC Clin Electrophysiol,2022,8(1):115-117.
[36] Morani G,Bolzan B,Pepe A,et al. Leadless pacemaker through tricuspid bioprosthetic valve:early experience[J]. J Arrhythm,2021,37(2):414-417.
[37] Garweg C,Duchenne J,Vandenberk B,et al. Evolution of ventricular and valve function in patients with right ventricular pacing-a randomized controlled trial comparing leadless and conventional pacing[J]. Pacing Clin Electrophysiol,2023,46(12):1455-1464.
[38] Dhindsa DS,Mekary W,El-Chami MF. Pacing and defibrillation consideration in the era of transcatheter tricuspid valve replacement[J]. Curr Cardiol Rep,2024,26(5):331-338.
[39] Beurskens N,Tjong F,de Bruin-Bon R,et al. Impact of leadless pacemaker therapy on cardiac and atrioventricular valve function through 12 months of follow-up[J]. Circ Arrhythm Electrophysiol,2019,12(5):e7124.
[40] Moore S,Chau KH,Chaudhary S,et al. Leadless pacemaker implantation:a feasible and reasonable option in transcatheter heart valve replacement patients[J]. Pacing Clin Electrophysiol,2019,42(5):542-547.
[41] Arps K,Li B,Allen JJ,et al. Association of leadless pacing with ventricular and valvular function[J]. J Cardiovasc Electrophysiol,2023,34(11):2233-2242.
[42] Ahmad S,Munir MB,Sharbaugh MS,et al. Causes and predictors of 30-day readmission after cardiovascular implantable electronic devices implantation:insights from nationwide readmissions database[J]. J Cardiovasc Electrophysiol,2018,29(3):456-462.
[43] Haddadin F,Majmundar M,Jabri A,et al. Clinical outcomes and predictors of complications in patients undergoing leadless pacemaker implantation[J]. Heart Rhythm,2022,19(8):1289-1296.

相似文献/References:

[1]牟秦娇 张玥 王楠.无导线起搏器在特殊人群中植入的研究进展[J].心血管病学进展,2023,(8):694.[doi:10.16806/j.cnki.issn.1004-3934.2023.08.006]
 MOU QinjiaoZHANG YueWANG Nan.Analysis of Implantation of Leadless Pacemakers in Special Populations[J].Advances in Cardiovascular Diseases,2023,(6):694.[doi:10.16806/j.cnki.issn.1004-3934.2023.08.006]
[2]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,(6):93.[doi:10.16806/j.cnki.issn.1004-3934.2025.01.019]
[3]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,(6):97.[doi:10.16806/j.cnki.issn.1004-3934.2025.02.001]
[4]王晓芳 魏飞宇 范洁.无导线起搏器植入右心室不同部位的研究[J].心血管病学进展,2025,(4):298.[doi:10.16806/j.cnki.issn.1004-3934.2025.04.003]
 WANG Xiaofang,WEI Feiyu,FAN Jie.Study on The Implantation of L eadless P acemaker in Different Parts of R ight Ventricle[J].Advances in Cardiovascular Diseases,2025,(6):298.[doi:10.16806/j.cnki.issn.1004-3934.2025.04.003]
[5]褚松筠 盛琴慧 周菁.优化程控改善Micra AV无导线起搏器的房室同步性——临床研究和专家建议[J].心血管病学进展,2025,(11):961.[doi:10.16806/j.cnki.issn.1004-3934.2025.11.001]
 CHU Songyun,SHENG Qinhui,ZHOU Jing.Optimize Programming of Leadless Pacemaker Micra AV to Improve Atrioventricular SynchronClinical Studies and Experts Recommendation[J].Advances in Cardiovascular Diseases,2025,(6):961.[doi:10.16806/j.cnki.issn.1004-3934.2025.11.001]
[6]马娟 范洁.无导线起搏器与传统起搏器并发症比较[J].心血管病学进展,2022,(9):819.[doi:10.16806/j.cnki.issn.1004-3934.2022.09.013]
 MA Juan,FAN Jie.Comparison of Complications Between Leadless Cardiac Pacemaker and Traditional Pacemaker[J].Advances in Cardiovascular Diseases,2022,(6):819.[doi:10.16806/j.cnki.issn.1004-3934.2022.09.013]

备注/Memo

备注/Memo:
基金项目:四川省自然科学基金面上项目(22NSFSC0801)
更新日期/Last Update: 2025-07-31