高龄患者电极导线拔除后再植入无导线起搏器的安全性及有效性分析
Safety and efficacy analysis of reimplanting leadless pacemakers in elderly patients after lead extraction
申岩 1昃峰 2李学斌 2李鼎 2周旭 2段江波 2吴寸草 2何金山 2王龙 2苑翠珍2
作者信息
- 1. 河南省新乡市中心医院心电图科,河南新乡 453000;北京大学人民医院心内科,北京 100044
- 2. 北京大学人民医院心内科,北京 100044
- 折叠
摘要
目的 探讨高龄患者电极导线拔除后再植入无导线起搏器(LP)的安全性及有效性.方法 回顾2020年1月至2023年10月期间在北京大学人民医院心脏电生理中心住院植入LP的高龄患者,将其分为因心脏植入电子装置(CIED)感染后再植入LP组(感染组)和非CIED感染植入LP组(非感染组).收集患者的病历资料及术后24 h、1个月、6个月、1年起搏器程控参数,对两组患者的基线数据、植入部位、植入起搏器类型、术中起搏参数及术后随访起搏参数进行统计学分析.结果 54例患者符合入选标准.感染组24例,非感染组30例,感染组年龄较非感染组小[(83.8±3.9)岁vs(87.3±4.0)岁,P<0.05)],左房内径较非感染组大[(45.5±7.4)mm vs(40.5±7.2)mm,P<0.05],其他数据资料无差异(P>0.05).感染组均成功拔除起搏器并植入LP成功,非感染组1例发生心脏压塞,经积极抢救后痊愈.与非感染组相比,感染组植入LP部位、起搏器类型、术中植入起搏参数、植入并发症无差异(P>0.05).两组植入LP后6个月、1年感知感染组较非感染组小[(9.5±3.3)mV vs(12.1±3.5)mV,(10.2±3.1)mV vs(12.3±3.1)mV,P均<0.05)],其余术后起搏参数均无差异.结论 高龄患者电极导线拔除后再植入LP安全有效.
Abstract
Objective To investigate the safety and efficacy of reimplanting leadless pacemakers in elderly patients after transvenous lead extractionremoval. Methods A retrospective review was conducted on the clinical data of elderly patients who were hospitalized at the Cardiac Electrophysiology Center of Peking University People's Hospi-tal and underwent leadless pacemaker (LP)implantation from January 2020 to October 2023.The patients were di-vided into two groups:LP implantation after CIED infection (infection group)and LP implantation without CIED infection (noninfection group).Medical records and programmed parameters of LP at 24 hours,1 month,6 months,and 1 year post-implantation were collected.Statistical analysis was performed on baseline data,implanta-tion site,type of LP implanted,intraoperative pacing parameters,and postoperative pacing parameters for both groups. Results 54 patients met the inclusion criteria.There were 24 cases in the infected group and 30 cases in the non infected group.The age of the infected group was younger than that of the non infected group[(83.8±3.9) years vs (87.3±4.0)years,P<0.05].The baseline data of the two groups of patients showed no differences (P>0 .05 ),except for the left atrial diameter in the infection group which was larger than the non infection group[(45.5±7.4)mm vs (40.5±7.2)mm].The infection group successfully removed the pacemaker and implanted LP,while the non infection group experienced 1 case of pericardial tamponade,which was cured after active rescue.Com-pared with the non infected group,there was no signif-icant difference in LP implantation site,pacemaker type,intraoperative implantation pacingparameters,and implantation complications in the infected group (P>0.05). There was a statistically significant difference (P<0.05)between the infected group and the non infected group in terms of perception[(9.5±3.3)mV vs (12.1±3.5)mV]at 6 months and perception[(10.2±3.1)mV vs (12.3±3.1)mV]at 1 year after LP implantation,while there was no difference in other postoperative pacing parameters. Conclusion Reimplantation of electrode leads in LP is safe and effective in elderly patients.
关键词
心血管病学/高龄/经静脉电极导线拔除/心脏植入电子装置感染/无导线起搏器/无导线起搏器再植入Key words
Cardiology/Elderly/Transvenous lead extraction/Cardiac implantable electronic device infection/Leadless pacemaker/Leadless pacemaker re-implantation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据