无导线起搏器植入术后阈值变化的研究进展  

Threshold Changes After Leadless Pacemaker Implantation

作　　者：张能 邢强[1] 汤宝鹏[1] ZHANG Neng;XING Qiang;TANG Baopeng(Department of Cardiac Pacing and Electrophysiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心起搏电生理科,新疆乌鲁木齐830054

出　　处：《心血管病学进展》2025年第2期97-101,共5页Advances in Cardiovascular Diseases

基　　金：国家自然科学基金(82260065,82370326)。

摘　　要：无导线起搏器植入术后阈值升高会缩短起搏器寿命或使设备无法运行。文献表明,固定牢靠是获得良好阈值的前提条件,炎症和纤维化可能是无导线起搏器植入术后阈值升高的原因。心脏延迟钆增强核磁显像是定量和定性心肌瘢痕和纤维化的非侵入性金标准,研究显示使用心脏延迟钆增强核磁显像可以改善心脏再同步化治疗的临床效果。心脏延迟钆增强核磁显像有望与无导线起搏器植入过程相结合,指导无导线起搏器植入最佳部位,避免植于瘢痕及纤维化心肌区域,以期获得良好电学参数,达到满意的临床效果。Elevated threshold after leadless pacemaker implantation can shorten the lifespan of the pacemaker or render the device inoperable.The studies suggested that secure fixation is the prerequisite for obtaining the good threshold,while inflammation and fibrosis may be the causes of elevated threshold after leadless pacemaker implantation.Late gadolinium enhanced cardiac magnetic resonance imaging is the non-invasive gold standard for quantitative and qualitative assessment of myocardial scars and fibrosis.Studies have shown that the use of late gadolinium enhanced cardiac magnetic resonance imaging can improve the clinical efficacy of cardiac resynchronization therapy.Late gadolinium enhanced cardiac magnetic resonance imaging is expected to be combined with the implantation process of leadless pacemakers to guide the optimal implantation site,avoid implantation in scar and fibrotic myocardial areas,and obtain good electrical parameters,achieving satisfactory clinical outcomes.

关 键 词：无导线起搏器 起搏阈值 心脏延迟钆增强核磁显像 炎症 心肌纤维化 

分 类 号：R541.7[医药卫生—心血管疾病]