摘要
目的观察Micra^TM Transcatheter Pacing System无导线起搏器(Micra无导线起搏器)的植入背景和术中、术后并发症发生情况及其影响因素。方法前瞻性、观察性研究,入选中国澳门镜湖医院2016年1月至2019年6月植入Micra无线起搏器患者80例,其中男性42例,女性38例,平均年龄81.6岁,最大102岁。分别在出院前、植入后1、3、6、12、24个月进行随访,收集起搏器电学参数和不良事件。结果实施Micra植入术患者手术时间(49.0±15.1)min,X线光曝光时间(8.3±4.0)min。植入时电学参数:阻抗(803.2±233.8)Ω、感知(9.1±4.4)mV、阈值(0.6±0.3)V/0.24 ms,住院天数3~5 d。围术期内,早期并发症(植入术后3个月内)术后穿刺点血肿(3.8%,3/80)、心包填塞(2.5%,2/80)、穿刺点动静脉瘘(1.3%,1/80)、起搏器感知不良/阈值过高(2.5%,2/80)、起搏器综合征(1.3%,1/80),平均随访1.48年,无中远期并发症。结论与传统起搏器相比,Micra无导线起搏器操作简单、微创,避免导线和囊袋相关并发症,手术时间短、术后恢复快,为符合单腔起搏器植入适应证的患者带来新的选择。
Objective To analyze the background,intra-and post-operative complications and the influencing factors in patients implanted with leadless pacemakers using the Micra^TM transcatheter pacing system(Micra TPS).Methods A total of 80 patients implanted with the Micra leadless transcatheter pacemaker(42 males and 38 females,mean age=81.6 years,with a maximum age of 102 years)in China Kiang Wu Hospital between January 2016 and June 2019 were enrolled in this prospective,observational study.Follow-up was conducted at pre-hospital discharge,1,3,6,12,24 months after implantation,and the pacing parameters and adverse events were collected.Results The average operation time was 49.0±15.1 minutes,and the average X-ray exposure time was(8.3±4.0)minutes.Electrical parameters including impedance,sensing amplitude and threshold at implantation were(803.2±233.8)Ω,(9.1±4.4)mV and(0.6±0.3)V/0.24 ms,respectively.The length of hospital stay was 3-5 days.The incidences of early complications(within 3 months after implantation),postoperative local hematoma at puncture point,intraoperative cardiac tamponade,arteriovenous fistula at puncture point,poor pacemaker capture/high threshold,and pacemaker syndrome were 3.8%(3/80),2.5%(2/80),1.3%(1/80),2.5%(2/80),and 1.3%(1/80),respectively.The mean follow-up was 1.48 years,and no mid-or long-term complications were found.Conclusions Compared with traditional pacemakers,the Micra leadless transcatheter pacemaker is easy to operate,minimally invasive,and capable of preventing complications associated with wires and bags,with a short operation time and quick postoperative recovery,and may be a new alternative for patients in need of single-chamber ventricular pacing.
作者
牛云茜
柯于梵
易敏慈
Niu Yunqian;Ke Yufan;Yi Minci(Department of Cardiology,Kiang Wu Hospital of Macao,Macao 999078,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2020年第7期787-790,共4页
Chinese Journal of Geriatrics
