主动固定电极导线脱位的临床特点及处理措施

Active-fixation lead displacement in pacemaker implantation: Clinical characteristics and management

目的主动固定电极导线广泛应用于临床,电极导线脱位是心脏起搏器置入术的严重并发症,文中旨在探讨主动固定电极导线脱位的临床特点及处理措施。方法回顾性分析1341例起搏器植入患者中,电极导线脱位的临床资料及处理措施。结果电极脱位患者12例,有13根电极导线脱位。其中9根主动固定电极导线脱位,包括心房主动电极2根及心室主动电极7根;3根主动固定电极导线脱位发生于术后1个月内,6根发生于术后1个月后。4根被动电极导线脱位,包括心房电极2根及心室电极2根,均发生于术后1个月内。所有脱位主动固定电极均被安全拔除。结论主动固定电极导线脱位发生率与被动电极相似,但远期脱位率呈增多趋势。在起搏器安装时要采取必要的措施预防电极脱位。

Objective Active-fixation lead （AFL） is widely applied in pacemaker implantation, but has a severe complication of lead displacement. This study is to explore the clinical characteristics of AFL dislocation and the measures for its management. Methods We retrospectively analyzed the clinical data of 1341 cases of pacemaker implantation, particularly the factors related to AFL displacement and the treatment measures. Results Lead displacement was found in 12 patients, including 9 AFLs and 4 passive leads. The 9 dislocated AFLs included 2 atria leads and 7 ventricular leads, of which 3 occurred within 1 month and the other 6 after 1 month postoperatively. The 4 displaced passive leads included 2 atria and 2 ventrieular leads, which all occurred within 1 month after operation. All the dislocated AFI_s were removed safely. Conclusion The displacement rate of AFLs is similar to that of passive leads, the former with a higher rate of long-term dislocation. Necessary preventive measures should be taken during pacemaker implantation.