心脏植入电子装置相关感染性心内膜炎经静脉拔除导线的安全性分析  

Safety analysis of transvenous lead extraction in patients with cardiac implantable electronic device related infective endocarditis

作　　者：申岩[1,2] 昃峰 李学斌[2] 李鼎[2] 王龙[2] 段江波[2] 吴寸草[2] 何金山[2] 周旭[2] 苑翠珍 SHEN Yan;ZE Feng;LI Xuebin;LI Ding;WANG Long;DUAN Jiangbo;WU Cuncao;HE Jinshan;ZHOU Xu;YUAN Cuizhen(Department of Electrocardiogram,Xinxiang Central Hospital,Xinxiang 453002,China;Department of Cardiology,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]新乡市中心医院心电图科,新乡453002 [2]北京大学人民医院心内科,北京100044

出　　处：《中国心脏起搏与心电生理杂志》2025年第1期43-47,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：北京大学人民医院研究与发展基金(2022PHB284-001)。

摘　　要：目的探讨心脏植入电子装置(CIED)相关感染性心内膜炎经静脉拔除导线的安全性和有效性。方法回顾性分析2013年1月至2020年12月期间在北京大学人民医院心脏电生理中心因CIED感染致感染性心内膜炎经静脉拔除导线的患者,依据心脏超声赘生物大小分为小赘生物组(赘生物长径<20 mm)和大赘生物组(赘生物长径≥20 mm)。比较两组患者的基线特征、心脏超声参数和血培养结果及电极导线拔除方法和拔除成功率。结果共纳入患者44例,小赘生物组35例和大赘生物组9例。两组患者的基线特征无统计学差异(P>0.05)。植入心脏再同步化治疗装置经静脉拔除导线两组间比较,差异有统计学意义(P<0.05)。两组患者导线拔除方法和围手术期并发症差异无统计学意义(P>0.05)。仅1例患者导线头端残留2 cm拔除失败。共有4例患者围手术期出现并发症。结论CIED相关感染性心内膜炎经静脉拔除电极导线安全有效。Objective To investigate the safety and effectiveness of transvenous lead extraction in patients with infective endocarditis associated with cardiac implantable electronic device(CIED).Methods A retrospective analysis was conducted on patients with infective endocarditis caused by CIED infection who underwent transvenous lead extraction at the Cardiac Electrophysiology Center of Peking University People′s Hospital between January 2013and December 2020.Patients were categorized into two groups based on the size of the vegetation detected by cardiac ultrasound:the small vegetation group(vegetation length<20mm)and the large vegetation group(vegetation length≥20mm).The baseline characteristics,cardiac ultrasound parameters,blood culture results,electrode lead extraction methods,and extraction success rates were compared between the two groups.Results A total of 44patients were included,with 35in the small vegetation group and 9in the large vegetation group.No statistically significant differences were observed in the baseline characteristics between the two groups(P>0.05).There was a statistically significant difference(P<0.05)between the two groups in terms of the lead removal via intravenous route following the implantation of a cardiac resynchronization therapy device.However,There was no significant difference in lead removal methods and perioperative complications between the two groups of patients(P>0.05).Only one patient failed to remove a 2cm residual lead tip.A total of four patients experienced complications during the perioperative period.Conclusion The removal of electrode leads via venous route is safe and effective for treating CIED-related infective endocarditis.

关 键 词：心脏植入电子装置感染 感染性心内膜炎 经静脉电极导线拔除 

分 类 号：R654.2[医药卫生—外科学]