中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2014年
5期
357-359
,共3页
蓝荣芳%吉文庆%狄文成%李晓宏%余洪松%王如兴%顾翔%杜荣增%徐伟
藍榮芳%吉文慶%狄文成%李曉宏%餘洪鬆%王如興%顧翔%杜榮增%徐偉
람영방%길문경%적문성%리효굉%여홍송%왕여흥%고상%두영증%서위
心脏再同步治疗%经皮腔内冠状动脉成型术导丝%左心室导线
心髒再同步治療%經皮腔內冠狀動脈成型術導絲%左心室導線
심장재동보치료%경피강내관상동맥성형술도사%좌심실도선
Cardiac resynchronization therapy%Percutaneous transluminal coronary angioplasty guidewire%Left ventricular lead
目的 探讨左心室导线内留置导丝技术的安全性.方法 为固定反复脱位的左心室导线,2009年2月至2014年2月江苏省多中心共有12例接受心脏再同步治疗(CRT)或心脏再同步治疗除颤器(CRT-D)的患者,左心室起搏导线内留置了经皮腔内冠状动脉成型术(PTCA)导丝.随访观察患者的起搏阈值、阻抗及X线胸片.结果 有1例于术后6个月出现X线影像上可辨认的导线断裂.有2例在术后1个月出现起搏阈值升高伴膈神经刺激,行左心室导线重置术中见留置导丝断裂.有2例分别于术后1、3个月出现起搏阈值升高,随访至今(1～3年)未见起搏阈值继续升高,阻抗及X线影像未见异常.有7例随访至今(1.5 ～4.0年)起搏阈值、阻抗以及X线影像均未见异常.结论 左心室导线内留置导丝有损伤导线的风险,临床应禁止使用.
目的 探討左心室導線內留置導絲技術的安全性.方法 為固定反複脫位的左心室導線,2009年2月至2014年2月江囌省多中心共有12例接受心髒再同步治療(CRT)或心髒再同步治療除顫器(CRT-D)的患者,左心室起搏導線內留置瞭經皮腔內冠狀動脈成型術(PTCA)導絲.隨訪觀察患者的起搏閾值、阻抗及X線胸片.結果 有1例于術後6箇月齣現X線影像上可辨認的導線斷裂.有2例在術後1箇月齣現起搏閾值升高伴膈神經刺激,行左心室導線重置術中見留置導絲斷裂.有2例分彆于術後1、3箇月齣現起搏閾值升高,隨訪至今(1～3年)未見起搏閾值繼續升高,阻抗及X線影像未見異常.有7例隨訪至今(1.5 ～4.0年)起搏閾值、阻抗以及X線影像均未見異常.結論 左心室導線內留置導絲有損傷導線的風險,臨床應禁止使用.
목적 탐토좌심실도선내류치도사기술적안전성.방법 위고정반복탈위적좌심실도선,2009년2월지2014년2월강소성다중심공유12례접수심장재동보치료(CRT)혹심장재동보치료제전기(CRT-D)적환자,좌심실기박도선내류치료경피강내관상동맥성형술(PTCA)도사.수방관찰환자적기박역치、조항급X선흉편.결과 유1례우술후6개월출현X선영상상가변인적도선단렬.유2례재술후1개월출현기박역치승고반격신경자격,행좌심실도선중치술중견류치도사단렬.유2례분별우술후1、3개월출현기박역치승고,수방지금(1～3년)미견기박역치계속승고,조항급X선영상미견이상.유7례수방지금(1.5 ～4.0년)기박역치、조항이급X선영상균미견이상.결론 좌심실도선내류치도사유손상도선적풍험,림상응금지사용.
Objective To investigate the safety of retained guidewire in left ventricular lead.Methods The retained percutaneous coronary intervention(PTCA) guidewire technique had been used in 12 patients for repetitive intraoperative dislocation.The threshold and the impendence of the left ventricular lead were recorded during follow-up.The patients with abnormal parameters took chest X-ray.Results Lead fracture was demonstrated by X-ray 6 months after implant in 1 patient.The marked increase in pacing threshold was recorded one month after implant in 2 patients with phrenic nerves stimulation as well as guidewire fracture.There was pacing threshold increase in 2 patients without changes of impendence and X-ray for 1 to 3 years.There were no changes in threshold,impendence as well as X-ray in 7 patients for 1.5 to 4.0 years.Conclusion Retained guidewire technique should be forbidden because it can damage the lead.
