经静脉途径拔除起搏电极导线36例临床分析  

Clinical analysis of 36 cases undergoing transvenous lead extraction procedure

作　　者：郑钰萍 陈颖[1] 谭朝迪 刘眷璋 吴涛[1] 耿登峰[1] 周淑娴[1] ZHENG Yu-ping;CHEN Ying;TAN Chao-di;LIU Juan-zhang;WU Tao;GENG Deng-feng;ZHOU Shu-xian(Division of Cardiology,Sun Yat-Sen Memorial Hospital,Sun Yat-San University,Guangzhou 510120,Guangdong,China)

机构地区：[1]中山大学孙逸仙纪念医院心内科,广东广州510120

出　　处：《中国心脏起搏与心电生理杂志》2022年第6期516-518,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金(81870294)。

摘　　要：目的 分析和总结心脏植入型电子器械患者经静脉途径拔除起搏电极导线的诊治情况。方法 回顾性分析2014年1月至2020年12月于本院行起搏电极拔除术患者的临床资料。结果 共36例行电极拔除术的患者,其中起搏系统感染患者29例,电极故障6例,血栓形成1例。共拔除电极导线69根(心房电极27根,右室电极33根,左室电极4根,埋藏式心脏转复除颤器电极5根。所有电极的平均植入时间为(45±46)个月。电极拔除成功率100%(均为完全拔除);其中10根(14.5%)直接拔除,32根(46.4%)使用锁定钢丝拔除,12根(17.4%)应用锁定钢丝联合扩张鞘拔除,12根(17.4%)应用锁定钢丝联合evolution机械鞘拔除,3根(4.3%)应用Snare下腔回收装置拔除。1例在置入临时起搏电极时因电极穿孔致心脏压塞,1例术中发生重度三尖瓣返流。结论 起搏系统感染是拔除电极的主要原因,经静脉途径拔除起搏电极导线具有较高的成功率。Objective To analyze and summarize the clinical characteristics of patients with cardiac implantable electronic devices(CIEDs) during transvenous lead extraction(TLE) procedure. Methods Retrospectively analyzed the clinical data of patients who underwent TLE procedure in Sun Yat-Sen Memorial Hospital from Jan 1, 2014 to Dec 31, 2020. Results A total of 36 patients underwent TLE procedure(29 patients with CIEDs system infection, 6 patients with lead malfunction and 1 patient with thrombosis). Sixty-nine leads(27 leads in atrium, 33 in right ventricular, 4 in left ventricular and 5 defibrillation leads) were extracted. The mean duration of the implanted leads was(45±46) months(range 1-156 months). The success rate of lead extraction was 100%(all of them were completely removed). 10 leads(14.5%) were extracted using simple traction alone, while the remaining leads requiring the use of extraction tools. The incidence of complications was 5.5% with 1 case of cardiac tamponade and 1 case of severe tricuspid regurgitation. Conclusions CIEDs system infection is the main reason for the TLE procedure, which has a relative high success rate. [Chinese Journal of Cardiac Pacing and Electrophysiology,2022,36(6):516-518]

关 键 词：心血管病学 心脏植入型电子器械 经静脉途径电极拔除 感染 

分 类 号：R318.11[医药卫生—生物医学工程] R6193[医药卫生—基础医学]