老年缓慢性心律失常患者应用Micra无导线起搏器治疗效果观察  

Therapeutic effect of Micra leadless pacemaker in elderly patients with bradyarrhythmia

作　　者：周奇 郭万刚 张明明 王建刚 胡清 杨莉 贺静 薛晓珍 ZHOU Qi;GUO Wangang;ZHANG Mingming;WANG Jiangang;HU Qing;YANG Li;HE Jing;XUE Xiaozhen(Department of Cardiology,Xi'an Baoshihua Changqing Hospital,Xi'an,Shaanci 71020l,China;Department of Cardiology,Air Force Military Medical University Tangdu Hospital,Xi'an,Shaanci 710000,China)

机构地区：[1]西安宝石花长庆医院心血管内科,陕西西安710201 [2]空军军医大学唐都医院心血管内科,陕西西安710000

出　　处：《中华实用诊断与治疗杂志》2023年第8期767-770,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：创新人才推进计划-青年科技新星项目(2022KJXX-107)。

摘　　要：目的探讨老年缓慢性心律失常患者应用Micra无导线起搏器治疗的效果及安全性。方法2020年1月—2023年1月西安宝石花长庆医院诊治老年缓慢性心律失常患者19例,均植入Micra无导线起搏器治疗,观察手术成功率、起搏器释放次数、起搏器参数(术中阈值、术中感知、术中阻抗)、手术时间、住院时间及围手术期并发症发生情况。术后随访6~12个月,观察起搏器参数及起搏器脱落或移位发生情况。结果19例患者均完成Micra无导线起搏器植入,成功率为100%。19例患者起搏器释放次数(1.41±0.62)次,术中阈值(0.62±0.33)V/0.24 ms,术中感知(9.76±3.54)mV,术中阻抗(858.82±216.33)Ω,手术时间(73.47±21.33)min,住院时间(11.65±5.23)d;围手术期均未发生空气栓塞、血栓栓塞、心脏穿孔等严重并发症,无股动脉瘤、起搏器脱落或移位等情况。随访(10.0±1.7)个月,1例(术中阈值1.25 V/0.24 ms)术后12个月时起搏器参数异常,阈值3.75 V/0.24 ms,预计起搏器使用时间为22个月;1例(术中阈值1.25 V/0.24 ms)随访过程中阈值下降(<1 V/0.24 ms),对起搏器使用时间无影响;余17例起搏器参数均良好,术后12个月时阈值(0.56±0.21)V/0.24 ms,感知(10.01±2.64)mV,阻抗(853.53±167.96)Ω;19例患者均未发生起搏器脱落或移位。结论老年缓慢性心律失常患者应用Micra无导线起搏器治疗安全、有效,术中及术后并发症发生率低,术后随访起搏器参数良好。Objective To explore the efficacy and safety of Micra leadless pacemaker in the treatment of elderly bradyarrhythmia.Methods From January 2020 to January 2023,19 elderly patients with bradyarrhythmia were diagnosed and treated in Xi'an Baoshihua Changqing Hospital.All patients were implanted with Micra leadless pacemakers.The success rate of operation,number of deployment,pacing parameters(intraoperative threshold,intraoperative R-wave amplitude,intraoperative impedance),procedure duration,length of hospital stay,and perioperative complications were observed.All patients were followed up for 6 to 12 months after operation to observe the pacemaker electrocardiogram parameters and the occurrence of pacemaker detachment or dislodgement.Results All 19patients completed Micra leadless pacemaker implantation,with a success rate of 100%.The number of deployment was(1.41±0.62),the intraoperative threshold was(0.62±0.33)V/0.24 ms,the R-wave amplitude was(9.76±3.54)mV,the intraoperative impedance was(858.82±216.33)Ω,the procedure lasted for(73.47±21.33)min,and the length of hospital stay was(11.65±5.23)d.There were no serious perioperative complications such as air embolism,thromboembolism or cardiac perforation,and no femoral artery aneurysm,pacemaker detachment or dislodgement occurred.During the follow-up of(10.0±1.7)months,one patient with intraoperative threshold of 1.25 V/0.24 ms had abnormal pacing parameters at 12 months of follow-up,with a threshold of 3.75 V/0.24 ms,and the expected duration of pacemaker use was 22 months;one patient with intraopercative threshold of 1.25 V/0.24 ms had a decrease in threshold(<1 V/0.24 ms)during follow-up,which had no effect on the pacemaker duration;the remaining 17 patients had good pacing parameters,with a threshold of(0.56±0.21)V/0.24 ms,R-wave amplitude of(10.01±2.64)mV,and impedance of(853.53±167.96)Ωat 12 months of follow-up;no pacemaker dislocation or dislodgement occurred in 19patients.Conclusion Micra leadless pacemaker is safe and effective in the treatment

关 键 词：缓慢性心律失常 老年 Micra无导线起搏器 安全性 

分 类 号：R541.7[医药卫生—心血管疾病]