摘要
目的评估经导管植入无导线Micra起搏器系统(Medtronic)临床应用的安全性和有效性。方法入选2020年8月至2021年11月期间符合无导线起搏推荐意见适应证的患者植入无导线Micra起搏器系统。观察和评估手术持续时间(从股静脉穿刺到静脉通路闭合)、X线透视时间、器械回收重新释放次数、围手术期起搏器程控检测(感知、阈值和阻抗)以及住院期间手术并发症发生情况。所有患者在术后1、3、6个月随访检测起搏器参数,观察手术相关的中长期不良事件。结果入选20例患者,均经导管均成功植入无导线Micra无导线起搏器,无严重并发症发生,手术成功率100%。平均手术时间(38.5±3.3)min,平均X线透视时间(10.8±6.1)min,平均Micra起搏器释放次数(1.56±0.75)次,其中14例患者1次释放成功,3例患者2次释放成功,1例患者3次释放成功,2例患者回收释放次数大于5次。Micra无导线起搏器植入部位首选在右中位室间隔成功植入14例,高位间隔4例,低位间隔2例。术中平均起搏阈值(0.50±0.21)V,心室感知(8.87±1.52)mV,阻抗为(758.9±187.9)Ω。出院时、术后1、3及6个月随访,20例患者的起搏器阈值、感知及阻抗未见明显变化,无手术相关不良事件发生。结论经导管植入无导线Micra无导线起搏器手术安全可行。
Objective To evaluate the safety and efficacy of transcatheter implantation of leadless Micra pacemaker system(Medtronic)in clinical application.Methods The patients who were implanted with the leadless Micra pacemaker system according to the recommended guidelines were selected from August 2020 to November 2021.The operation duration(from femoral vein puncture to venous access closure),X-ray fluoroscopy time,instrument retrieving times,electric parameters detection(sensing,threshold and impedance)during perioperative period,and the occurrence of complications during hospitalization were observed.All patients were followed up at 1,3 and 6 months after operation to observe the pacemaker parameters and adverse events related to operation.Results A total of 20 patients were included and successfully implanted with leadless Micra pacemakers without serious complications.The success rate of operation was 100%.The average operation time was(38.5±3.3)min;the average fluoroscopy time was(10.8±6.1)min;the average Micra pacemaker release times were(1.56±0.75).The successful released time of Micra was only once in 14 patients,two times in 3 patients,three times in one patient,and more than five times in 2 patients.Micra leadless pacemaker was successfully implanted in the right median interventricular septum in 14 cases,high interventricular septum in 4 cases and low septal septum in 2 cases.The average pacing threshold during operation was(0.50±0.21)V,ventricular sensing was(8.87±1.52)mV,and the impedance was(758.9±187.9)Ω.At 1,3 and 6 months after operation,the pacemaker threshold,sensing and impedance levels in all patients did not change significantly,and no operation related adverse events occurred.Conclusions Transcutaneous implantation of leadless Micra leadless pacemaker is safe and feasible.
作者
刘滕飞
丁春华
张凯
杜婉婷
林涛
李广平
Liu Tengfei;Ding Chunhua;Zhang Kai;Du Wanting;Lin Tao;Li Guangping(Department of Cardiology,Aerospace Center Hospital,Beijing 100049,China;Department of Cardiology,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China;Department of Cardiology,Tianjin Medical University Second Hospital,Tianjing 300211,China)
出处
《中国心血管杂志》
2023年第4期313-317,共5页
Chinese Journal of Cardiovascular Medicine
基金
中国铁路总公司科技研究开发计划课题(J2017Z608)
首都医科大学附属北京世纪坛医院院青年基金(2017-q27)
中心实验室开放课题(2019-FK28)
关键词
无导线起搏器
安全性
随访
并发症
Leadless pacemaker
Safety
Followed up
Complications
