Micra AV无导线起搏器植入术后随访优化对房室同步率的影响  

The impact of programming optimization for atrioventricular synchrony after Micra AV leadless pacemakers implantation

作　　者：郑泽[1] 史雨晨[1] 何松原 王韶屏[1] 李世英[1] 程姝娟[1] 柳景华[1] ZHENG Ze;SHI Yu-chen;HE Song-yuan;WANG Shao-ping;LI Shi-ying;CHENG Shu-juan;LIU Jing-hua(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Cardiopulmonary and Vascular Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京市心肺血管疾病研究所,北京100029

出　　处：《中国介入心脏病学杂志》2024年第2期71-75,共5页Chinese Journal of Interventional Cardiology

基　　金：国家自然科学基金项目(82170344)。

摘　　要：目的分析Micra AV无导线起搏器植入术后的房室同步率,探讨术后程控优化对房室同步率的影响。方法采用前瞻性队列研究,选取2022年8月至2023年6月于首都医科大学附属北京安贞医院行Micra AV无导线起搏器植入的持续三度房室传导阻滞患者,于术后1周、1个月和3个月分别进行程控和优化,记录房室同步率、电学参数和超声心动图等。结果共入选68例植入Micra AV的三度房室传导阻滞患者,平均年龄(68.2±9.7)岁,其中男47例(69.1%)。所有患者均成功植入Micra AV,术后无严重并发症发生;术中和术后1周、1个月、3个月的平均阈值、感知、阻抗参数稳定;术后超声心动图左心室射血分数变化差异无统计学意义(P=0.162);术后1周、1个月、3个月的平均房室同步率分别为(75.2%比83.8%比91.6%,P=0.001),差异有统计学意义。结论Micra AV作为心房机械感知,需要个性化来调整相关参数。术后随访程控和优化对于三度房室传导阻滞患者植入Micra AV后的房室同步起搏和舒适度体验具有重要作用。Objective To analyze the atrioventricular synchronization rate after implantation of Micra AV leadless pacemaker,and the impact of postoperative programming optimization on atrioventricular synchronization rate.Methods A prospective cohort study was conducted to select patients with complete atrioventricular block who underwent Micra AV leadless pacemaker implantation at Beijing Anzhen Hospital from August 2022 to June 2023.Programming optimization were performed at 1 week,1 month,and 3 months postoperatively,and atrioventricular synchronization rate,electrical parameters,and echocardiography were recorded.Results A total of 68 patients with complete atrioventricular block implanted with Micra AV were selected,with an average age of(68.2±9.7)years,including 47 males(69.1%).All patients were successfully implanted with Micra AV,and there were no serious postoperative complications;The average threshold,sense,and impedance parameters were stable during 1 week,1 month,and 3 months after the procedure;There was no significant diff erence in the EF value of postoperative echocardiography(P=0.162);The average atrioventricular synchronization rates at 1 week,1 month,and 3 months postoperatively were(75.2%vs.83.8%vs.91.6%,P=0.001).Conclusions As an mechanical atrial sensing,Micra AV requires personalized adjustment of relevant parameters;Postoperative follow-up programming optimization plays an important role in the atrioventricular synchronization and comfort level in patients with complete atrioventricular block after implantation of Micra AV leadless pacemaker.

关 键 词：无导线起搏器 程控 优化 房室同步率 

分 类 号：R541.7[医药卫生—心血管疾病]