Micra无导线起搏系统的临床应用研究  

The clinical research of the application of Micra leadless pacemaker system

作　　者：邢建东 徐伟 邢玉龙 XING Jian-dong;XU Wei;XING Yu-long(Department of Cardiology,Nanjing Gaochun People's Hospital,Nanjing 210008,Jiangsu,China;Department of Cardiology,Nanjing Drum Tower Hospital,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京市高淳人民医院心血管内科,江苏南京210008 [2]南京鼓楼医院心血管内科,江苏南京210008

出　　处：《中国心脏起搏与心电生理杂志》2024年第4期268-272,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的 探讨Micra无导线起搏器系统临床应用的安全性及有效性。方法 连续入选2020年1月至2022年12月在南京鼓楼医院住院治疗且具备Micra无导线起搏器系统植入适应证的心律失常患者41例。其中因囊袋感染电极导线拔除后再植入无导线起搏器21例(再植入LP组),首次植入无导线起搏器20例(首次植入LP组)。对比分析两组的手术时间、释放次数、X线曝光时间、起搏参数、并发症等数据。随访两组植入1、3、6及12个月时起搏参数情况。结果 所有患者均成功植入Micra无导线起搏器,起搏器植入部位为中高位室间隔。再植入LP组男性15例(71.4%),平均年龄(72.5±19.1)岁。首次植入LP组男性12例(60%),平均年龄(60.8±8.4)岁。再植入LP组与首次植入LP组相比,在手术时间、释放≤2次比例、X线曝光时间、起搏阈值、感知、阻抗之间均无差异(P均>0.05),两组均未发生手术及起搏器相关并发症和严重不良事件。两组患者在1、3、6及12个月随访时的起搏阈值、感知、阻抗均无差异(P均>0.05)。结论 Micra无导线起搏器植入安全可行,传统起搏器因感染并发症移除后更换无导线起搏器亦同样安全有效。Objective To explore the safety and effectiveness of the clinical application of the Micra leadless pacemaker(LP)system.Method A total of 4l patients with arrhythmia who were hospitalized at Nanjing Drum Tower Hospital from January 2020 to December 2022 and had indications for LP system were selected consecutively.Among them,there were 21 cases of LP implantation after removing the electrode wire because of infection(LP reimplantation group)and 20 cases of first time implantation of LP(LP first time implantation group).Compare and analyze the surgical time,release frequency,X-ray exposure time,pacing parameters,and complications between the two groups.Follow up the pacing parameters of two groups at 1,3,6,and 12 months after LP implantation.Result LP implantation of Micra system were selected in all patients and the implant site was the mid to high level of septum.Patients in LP reimplantion group included 15 males(71.4%)with an average age of(72.5±19.1)years.Patients in LP first time implantation group included 12 males(60%)with an average age of(60.8±8.4)years.There were no statistically significant differences in surgical time,the proportion of release≤2 times,X-ray exposure time,pacing threshold,perception,impedance between the two groups(P>0.05).No surgical and device related complications occurred.There were no statistically significant differences in pacing threshold,perception,and impedance between the two groups at 1 month,3 month,6 month,12 month of follow-up after LP implantation(P>0.05).Conclusion LP is a safe and feasible clinical choice not only for the first time implantation patients but also for the reimplantation patients after removal infected pacemaker.

关 键 词：心血管病学 无导线起搏器 心脏起搏器 感染 导线拔除 

分 类 号：R318.11[医药卫生—生物医学工程] R619.3[医药卫生—基础医学]