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Analyses of risk factors and prognosis for new-onset atrial fibrillation in elderly patients after dual-chamber pacemaker implantation 被引量:5
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作者 Xiao-Li CHEN Xue-Jun REN +3 位作者 Zhuo LIANG Zhi-Hong HAN Tao ZHANG Zhi LUO 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2018年第10期628-633,共6页
Objective To retrospectively identify risk factors and the prognosis for new-onset atrial fibrillation (AF)after implantation of dual-chamber pacemakers in elderly patients.Methods Consecutive patients aged >65year... Objective To retrospectively identify risk factors and the prognosis for new-onset atrial fibrillation (AF)after implantation of dual-chamber pacemakers in elderly patients.Methods Consecutive patients aged >65years who underwent their first implantation of a dual-chamber permanent pacemaker in Beijing Anzhen Hospital from October 2013to May 2016were enrolled.Their complete program- ming and follow-up data were recorded.Follow-up end points included new-onset AF and major adverse cardiovascular and cerebrovascular events.Restdts Altogether,322patients were enrolled,with new-onset AF observed in 79(24.5%)during their follow-up.Multivariable analysis identified four independent predictors of new-onset AF in elderly patients after pacemaker implantation:hypertension (HR =3.040, 95%CI:1.09-3.05,P =0.00),age (HR =1.966,95%CI:1.57-3.68,P =0.01);left atrial enlargement (HR =1.645,95%CI:1.05-1.25,P = 0.03);high ventricular pacing rate (HR =1.137,95%CI:1.01-1.06,P =0.01).Univariable analysis indicated that the CHA2DS2-VASc score was also a risk factor for AF (HR =1.368,95%CI:1.178-1.589,P =0.002),whereas multivariable regression analysis did not. Kaplan-Meier survival analysis showed that the risk for ischemic stroke was significantly higher in the new-onset AF group than in the non-AF group (P <0.05).Conclusion Hypertension,age,left atrial enlargement,and high ventricular pacing rate were independent predictors of new-onset AF in elderly patients after implantation of a permanent pacemaker.New-onset AF increased the risk for ischemic stroke. 展开更多
关键词 ATRIAL FIBRILLATION dual-chamber pacemaker Elderly Ischernic stroke
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Current knowledge for the risk factors of early permanent pacemaker implantation following transcatheter aortic valve replacement and what is next for the primary prevention?
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作者 Gen-Min Lin Wei-Chun Huang Chih-Lu Han 《World Journal of Cardiology》 2024年第2期54-57,共4页
In this editorial,we comprehensively summarized the preoperative risk factors of early permanent pacemaker implantation after transcatheter aortic valve replacement(TAVR)among patients with severe aortic stenosis from... In this editorial,we comprehensively summarized the preoperative risk factors of early permanent pacemaker implantation after transcatheter aortic valve replacement(TAVR)among patients with severe aortic stenosis from several renowned clinical studies and focused on the primary prevention of managing the modifiable factors,e.g.,paroxysmal atrial fibrillation before the TAVR. 展开更多
关键词 Permanent pacemaker implantation Transcatheter aortic valve replacement Interventricular conduction delay DIABETES Supraventricular arrhythmia
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Prediction of permanent pacemaker implantation after transcatheter aortic valve replacement:The role of machine learning 被引量:1
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作者 Pradyumna Agasthi Hasan Ashraf +16 位作者 Sai Harika Pujari Marlene Girardo Andrew Tseng Farouk Mookadam Nithin Venepally Matthew R Buras Bishoy Abraham Banveet K Khetarpal Mohamed Allam Siva K Mulpuru MD Mackram F Eleid Kevin L Greason Nirat Beohar John Sweeney David Fortuin David R Jr Holmes Reza Arsanjani 《World Journal of Cardiology》 2023年第3期95-105,共11页
BACKGROUND Atrioventricular block requiring permanent pacemaker(PPM)implantation is an important complication of transcatheter aortic valve replacement(TAVR).Application of machine learning could potentially be used t... BACKGROUND Atrioventricular block requiring permanent pacemaker(PPM)implantation is an important complication of transcatheter aortic valve replacement(TAVR).Application of machine learning could potentially be used to predict preprocedural risk for PPM.AIM To apply machine learning to be used to predict pre-procedural risk for PPM.METHODS A retrospective study of 1200 patients who underwent TAVR(January 2014-December 2017)was performed.964 patients without prior PPM were included for a 30-d analysis and 657 patients without PPM requirement through 30 d were included for a 1-year analysis.After the exclusion of variables with near-zero variance or≥50%missing data,167 variables were included in the random forest gradient boosting algorithm(GBM)optimized using 5-fold cross-validations repeated 10 times.The receiver operator curve(ROC)for the GBM model and PPM risk score models were calculated to predict the risk of PPM at 30 d and 1 year.RESULTS Of 964 patients included in the 30-d analysis without prior PPM,19.6%required PPM post-TAVR.The mean age of patients was 80.9±8.7 years.42.1%were female.Of 657 patients included in the 1-year analysis,the mean age of the patients was 80.7±8.2.Of those,42.6%of patients were female and 26.7%required PPM at 1-year post-TAVR.The area under ROC to predict 30-d and 1-year risk of PPM for the GBM model(0.66 and 0.72)was superior to that of the PPM risk score(0.55 and 0.54)with a P value<0.001.CONCLUSION The GBM model has good discrimination and calibration in identifying patients at high risk of PPM post-TAVR. 展开更多
关键词 Transcatheter aortic valve replacement Permanent pacemaker implantation Machine learning
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Successful leadless pacemaker implantation in a patient with dextroversion of the heart:A case report
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作者 Na Li Hai-Xiong Wang +1 位作者 Yue-Hui Sun Yan Shu 《World Journal of Clinical Cases》 SCIE 2023年第33期8089-8093,共5页
BACKGROUND Dextroversion is defined as the presence of dextrocardia with situs solitus,dextroloop ventricles,and normally related great arteries.Dextrocardia can pose technical challenges when interventional treatment... BACKGROUND Dextroversion is defined as the presence of dextrocardia with situs solitus,dextroloop ventricles,and normally related great arteries.Dextrocardia can pose technical challenges when interventional treatments are required.However,the challenges posed by dextroversion can be amplified due to the disruption of typical anatomical relationships,the unpredictable positioning and boundaries of cardiac structures resulting from the shift,and the pathological processes influencing rotation.CASE SUMMARY A 73-year-old woman with cardiac dextroversion suffered from a recurrence of atrial fibrillation after her radiofrequency catheter ablation and Despite the cessation of antiarrhythmic medications,there were episodes of sinus pauses and symptomatic bradycardia,with heart rates dropping as low as 28 beats per minute.CONCLUSION Dextroversion makes the implantation of leadless pacemakers more challenging,and appropriate adjustments in fluoroscope angles may be crucial for intracardiac operations.Additionally,when advancing delivery systems,attention should be paid to rotational direction during valve-crossing procedures;changes in the perspective of posture angle between normal cardiac position and dextroversion can serve as references. 展开更多
关键词 Leadless pacemaker DEXTROVERSION pacemaker implantation Case report
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Subclavian Arterial Bleeding during Permanent Pacemaker Implantation: Clinical Case Report and Literature Review
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作者 Si Dung Chu Giang Song Tran +1 位作者 Minh Thi Tran Thu Kim Thi Tran 《Open Journal of Emergency Medicine》 2023年第4期180-185,共6页
Research objective: To study a clinical case that had a complication of subclavian artery bleeding during permanent pacemaker implantation process. Subject and Method: Clinical case report and literature review. Study... Research objective: To study a clinical case that had a complication of subclavian artery bleeding during permanent pacemaker implantation process. Subject and Method: Clinical case report and literature review. Study of a patient had an indication for permanent pacemaker implantation who had complication of subclavian artery bleeding during the procedure. Result: An 84-year-old female patient was admitted to the hospital because of fainting spells with chest pain, on the background of dangerous complex arrhythmias and ischemic heart disease, and was prescribed a pacemaker for this patient. The patient had complication occurred during the procedure, which left subclavian artery bleeding was detected and treated promptly, a cardiac pacemaker was implanted on the right side of the chest, and the patient had a successful endovascular stent cover in the left subclavian artery. Conclude: Subclavian artery bleeding is a rare complication in the procedure of permanent pacemaker implantation, but it can still occur and requires quick detection and timely treatment, needs to be successful in cardiac pacemaker placement and subclavian artery drug-eluting stent cover placement intervention. Individualized patient risk assessment is needed;appropriate and standardized intervention techniques and experience can reduce the occurrence of this variable. 展开更多
关键词 COMPLICATION Subclavian Artery Bleeding Permanent pacemaker implantation
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Pacemaker post transcatheter aortic valve replacement:A multifactorial risk?
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作者 Stephane Noble Karim Bendjelid 《World Journal of Cardiology》 2024年第4期168-172,共5页
Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk.Nwaedozie et al brought to the body of evidence electrocardiogram and clinical findings.However,procedural characteristics have a... Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk.Nwaedozie et al brought to the body of evidence electrocardiogram and clinical findings.However,procedural characteristics have at least as much impact on the final need for a permanent pacemaker and potentially on the pacing rate.In this regard,long-term follow-up and understanding of the impact of long-term stimulation is of utmost importance. 展开更多
关键词 Transcatheter aortic valve replacement Permanent pacemaker implantation Conduction abnormalities Right bundle branch block Left bundle branch block
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Small balloon strategy associated with low pacemaker implantation rate after self-expanding transcatheter valve implantation 被引量:3
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作者 Yuan Zhang Wen-zhi Pan +8 位作者 Li-hua Guan Xiao-chun Zhang Sha-sha Chen Li-fan Yang Lei Zhang Ming-fei Li Dan-dan Chen Da-xin Zhou Jun-bo Ge 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2021年第1期48-53,共6页
BACKGROUND: This study aims to investigate whether small balloon aortic valvuloplasty(BAV) reduces the need for permanent pacemaker implantation (PPMI) after transcatheter aortic valveimplantation (TAVI).METHODS: This... BACKGROUND: This study aims to investigate whether small balloon aortic valvuloplasty(BAV) reduces the need for permanent pacemaker implantation (PPMI) after transcatheter aortic valveimplantation (TAVI).METHODS: This was a retrospective analysis using data from our local TAVI database. SmallBAV was defined as a small balloon size (=18 mm) pre-dilatation. Normal BAV was defined as aballoon size >18 mm. The primary endpoint was the incidence of new PPMI.RESULTS: Of 99 consecutive TAVI patients, five patients were excluded due to pre-existingpermanent pacemaker. Patients in the small BAV group (n=57) had a signifi cantly lower PPMI ratecompared with the normal BAV group (n=37) (3.5% vs. 18.9%, P=0.026). Moderate or severe aorticvalve regurgitation post-procedure was similar between the small BAV and normal BAV groups (5.3%vs. 8.1%, P=0.480);likewise, the mean aortic gradient post-procedure did not differ significantly(11.5±5.2 mmHg vs. 12.2±7.3 mmHg, 1 mmHg=0.133 kPa, P=0.580) between the groups. Devicesuccess rates were also similar (94.7% vs. 91.8%, P=0.680). In multivariable analysis, small BAV(P=0.027), the ratio of prosthesis diameter to annulus diameter (P=0.048), and mean aortic gradientby echo in the basement (P=0.021) were independent predictors of PPMI.CONCLUSIONS: The small BAV strategy is associated with a low rate of permanentpacemaker implantation after transcatheter self-expanding valve implantation in this single-centerobservational study. 展开更多
关键词 Transcatheter aortic valve implantation Balloon aortic valvuloplasty Balloon size Permanent pacemaker implantation
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Permanent transvenous pacemaker implantation in a patient with Cor triatriatum dextrum 被引量:1
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作者 Kun Xiang George V Moukarbel Blair Grubb 《World Journal of Cardiology》 CAS 2015年第1期43-46,共4页
Cor triatriatum dextrum is an extremely rare congenital heart abnormality in which the right atrium is separatedinto two chambers by a persistent fibrous membrane. A transvenous approach to place a dual-chamber pacema... Cor triatriatum dextrum is an extremely rare congenital heart abnormality in which the right atrium is separatedinto two chambers by a persistent fibrous membrane. A transvenous approach to place a dual-chamber pacemaker in such patients is technically challenging. We report the first case of a transvenous permanent pacemaker placement in a patient with cor triatriatum dextrum. An 87-year-old woman was diagnosed with paroxysmal atrial fibrillation. She was accidentally found to have cor triatriatum dextrum during the transesophageal echocardiography(TEE) prior to cardioversion. Later during her hospital stay, it was indicated to place a permanant pacemaker due to high grade atrioventricular block. After thorough reviewing TEE imagings, a transvenous catheter-based approach was decided feasible. Patient successfully received a dual chamber pacemaker through left subclavian venous approach. Furthermore in our case, using specially designed pacemaker leads and cautious intra-procedural maneuvering under fluoroscopic guidance ensured procedural success. In summary, a thorough pre-operative evaluation with transesophageal echocardiography is critical for the planning and eventual success of the transvenous placement of rightsided leads. 展开更多
关键词 CONGENITAL HEART defect Complete HEART block Inter-atrial membrane dual-chamber pacemaker
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Persistent left superior vena cava and pacemaker implantation
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作者 Daniele Pontillo Nicolino Patruno 《World Journal of Cardiology》 CAS 2013年第9期373-374,共2页
Our study group read with interest the paper from Vijayvergiya et al describing the implantation of an implantable cardioverter-defibrillator lead in the presence of the persistence of the left superior vena cava.The ... Our study group read with interest the paper from Vijayvergiya et al describing the implantation of an implantable cardioverter-defibrillator lead in the presence of the persistence of the left superior vena cava.The issue of the identification a persistent left superior vena cava is of paramount importance in interventional cardiology,being the most common venous anomaly of the thoracic distribution,and because it may create some problem to any physician while performing a pacemaker lead implantation.In our letter we underscore the specific issues related to pacemaker implantation while encountering a persistent left superior vena cava(and maybe the absence of the right vena cava)and the workup that should be performed to obtain the preoperative diagnosis of the venous anomaly.More specifically,we consider avoiding any kind of defibrillator lead implantation through the coronary sinus for safety issues,and underscore the straightforward transthoracic ultrasound approach to identify the left superior vena cava. 展开更多
关键词 Cardiovascular ANATOMY PERSISTENT superior vena cava pacemaker implantation CORONARY SINUS ECHOCARDIOGRAPHY
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Contralateral pneumothorax in the subacute phase after pacemaker implantation:lead retention and follow-up
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作者 Xiao-Dong CHEN Xu XU +2 位作者 Jia-Wen JI Hai-Lei LIU Jian-Ping SHEN 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2018年第12期744-746,共3页
An 89-year-old woman[body mass index(BMI)=20.27 kg/m^2)]with hypertension underwent implantation of a dual-chamber pacemaker because of dizziness and syncope due to sick sinus syndrome.Pacemaker implantation via the l... An 89-year-old woman[body mass index(BMI)=20.27 kg/m^2)]with hypertension underwent implantation of a dual-chamber pacemaker because of dizziness and syncope due to sick sinus syndrome.Pacemaker implantation via the left subclavian approach was performed on June 3,2017.A right ventricular active lead(TendrilTM STS 2088TC,St Jude Medical,Penang,Malaysia)and an atrial active lead(OptisenseTM 1999,St Jude Medical,Penang,Malaysia)were placed in the right ventricular apex and anterior wall of the right atrium,respectively. 展开更多
关键词 ATRIAL LEAD PERFORATION CONTRALATERAL PNEUMOTHORAX pacemaker implantation
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Successful transcatheter arterial embolization treatment for chest wall haematoma following permanent pacemaker implantation: A case report
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作者 Jing Zheng Xiao-Ming Tu Zhen-Yan Gao 《World Journal of Clinical Cases》 SCIE 2022年第32期11877-11881,共5页
BACKGROUND Haematoma is one of the main complications associated with pacemaker implantation.Pseudoaneurysm is a rare condition that is not easy to identify and is often overlooked.CASE SUMMARY A female patient diagno... BACKGROUND Haematoma is one of the main complications associated with pacemaker implantation.Pseudoaneurysm is a rare condition that is not easy to identify and is often overlooked.CASE SUMMARY A female patient diagnosed with high-grade atrioventricular block underwent permanent pacemaker implantation.During the operation,puncturing a small branch of the right subclavian artery developed into a pseudoaneurysm and resulted in further haematoma formation.Conventional treatment of compression haemostasis and haemostatic drugs was not effective.A series of timely transcatheter arterial embolizations avoided serious complications.CONCLUSION More possible conditions should be taken into consideration as haematoma is discovered,and timely treatment might prevent severe adverse events. 展开更多
关键词 Permanent pacemaker implantation HAEMATOMA PSEUDOANEURYSM Transcatheter arterial embolization Case report
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Implantation of an S-ICD in a Patient with a DDD Pacemaker and Congenitally Corrected Transposition of the Great Arteries
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作者 Yu Zhang Wen-Long Dai +2 位作者 Can-Can Lin Qiao-Yuan Li Cheng-Jun Guo 《Cardiovascular Innovations and Applications》 2021年第1期207-212,共6页
Subcutaneous implantable cardioverter-defi brillator(S-ICD)therapy has become a viable alternative to conventional transvenous ICD implantation.Patients with congenitally corrected transposition of the great arteries(... Subcutaneous implantable cardioverter-defi brillator(S-ICD)therapy has become a viable alternative to conventional transvenous ICD implantation.Patients with congenitally corrected transposition of the great arteries(ccTGA)have a high risk of sudden cardiac death due to malignant arrhythmia.The interaction between the S-ICD system and the transvenous pacemaker system is not fully understood.We report a case of S-ICD implantation in a patient with ccTGA and a DDD pacemaker.The patient was a 30-year-old man with a previously placed pacemaker with diagnoses of congenital heart disease,ccTGA(SLL),left atrioventricular valve insuffi ciency,and third-degree atrioventricular block.He presented with an out-of-hospital cardiac arrest,and an S-ICD was implanted to prevent sudden cardiac death.Defi brillation checks were performed successfully.We tested the compatibility of the DDD pacemaker with the S-ICD and found that there was no interference between them.In conclusion,an S-ICD system is a reasonable and safe option in patients with ccTGA. 展开更多
关键词 Subcutaneous implantable cardioverter-defi brillator congenitally corrected transposition of the great arteries pacemaker
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Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators:Outcome analysis using telemetry review 被引量:6
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作者 Justin R Cuschieri Mohammed N Osman +2 位作者 Richard CK Wong Amitabh Chak Gerard A Isenberg 《World Journal of Gastrointestinal Endoscopy》 CAS 2012年第3期87-93,共7页
AIM:To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).METH... AIM:To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).METHODS:Authors conducted a chart review of 20 patients with a cardiac pacemaker (CP) or implantable cardioverter defibrillator (ICD) who underwent continuous electrocardiographic monitoring during their SBCE from 2003-2008.authors searched for unexplained electrocardiogram (ECG) findings,changes in CP andICD set parameters,any abnormality in transmitted capsule data,and adverse clinical events.RESULTS:There were no adverse events or hemodynamically significant arrhythmias reported.CP and ICD set parameters were preserved.The majority of ECG abnormalities were also found in pre-or post-SBCE ECG tracings and the CP behavior during arrhythmias appeared appropriate.Two patients seemed to have episodes of undersensing by the CP.However,similar findings were documented in ECGs taken outside the time frame of the SBCE.One patient was observed to have a low signal encountered from the capsule resulting in lack of localization,but no images were lost.CONCLUSION:Capsule-induced EMI remains a possibility but is unlikely to be clinically important.CPinduced interference of SBCE is also possible,but is infrequent and does not result in loss of images transmitted by the capsule. 展开更多
关键词 Small bowel capsule endoscopy Cardiac pacemakerS implantable cardioverter DEFIBRILLATORS Electromagnetic interference TELEMETRY REVIEW
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Balloon venoplasty for disdialysis syndrome due to pacemakerrelated superior vena cava syndrome with chylothorax postbacteraemia: A case report
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作者 Satomi Yamamoto Michitsugu Kamezaki +4 位作者 Junichi Ooka Toru Mazaki Yoshiaki Shimoda Takaaki Nishihara Yoko Adachi 《World Journal of Clinical Cases》 SCIE 2023年第35期8364-8371,共8页
BACKGROUND Although superior vena cava(SVC)syndrome has also been reported as a late complication of pacemaker(PM)implantation,acute onset of SVC syndrome caused by disdialysis syndrome in patients with PM implantatio... BACKGROUND Although superior vena cava(SVC)syndrome has also been reported as a late complication of pacemaker(PM)implantation,acute onset of SVC syndrome caused by disdialysis syndrome in patients with PM implantation is very rare.There are no specific therapies or guidelines.CASE SUMMARY A 96-year-old woman receiving dialysis was implanted with a PM due to sick sinus syndrome.She was referred to our facility for chest discomfort experienced during dialysis.Upon examination,unilateral pleural effusion on the right side was cloudy with a foul odour.The patient was diagnosed with pyothorax and treated with antibiotics.After the effusion was reduced,it gradually reaggravated and remained cloudy.In this case,SVC syndrome,which is generally considered a late complication after PM implantation,rapidly developed following the bacteraemia,resulting in impaired venous return,chylothorax,and disdialysis syndrome.After catheter intervention for SVC stenosis,the patient’s symptoms promptly improved.The patient has been recurrence-free for a year.CONCLUSION Acute SVC syndrome can cause dysdialysis in PM-implanted patients.Catheter intervention alone has improved this condition for a traceable period. 展开更多
关键词 Superior vena cava syndrome pacemaker implantation complications Disdialysis Case report
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Interference between pacemakers/implantable cardioverter defibrillators and video capsule endoscopy 被引量:1
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作者 Dirk Bandorski Johannes Gehron Reinhard Hltgen 《World Journal of Gastrointestinal Endoscopy》 CAS 2013年第4期201-202,共2页
Our Letter to the Editor, related to the article "Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry" by Cuschieri... Our Letter to the Editor, related to the article "Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry" by Cuschieri et al , comments on some small errors, that slipped into the authors discussions. The given informations concerning the pacemakerand implantable cardioverter defibrillators modes were inaccurate and differ between the text and the table. Moreover, as 8 of 20 patient's pacemakers were programmed to VOO or DOO ("interference mode") and one patient was not monitored by telemetry during capsule endoscopy, 9 of 20 patients (45%) lack the informations of possible interference between capsule endoscopy their implanted device. Another objection refers to the interpretation of an electrocardiogram (figure 1, trace B) presented: in contrast to the author's opinion the marked spike should be interpreted as an artefact and not as "undersensing of a fibrillatory wave". Finally, three comments to cited reviews were not complete respectively not quoted correctly. 展开更多
关键词 CAPSULE ENDOSCOPY Small bowel CAPSULE ENDOSCOPY INTERFERENCE Cardiac pacemaker implantable cardioverter DEFIBRILLATOR Telemetry
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Conduction abnormalities after transcatheter aortic valve implantation
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作者 Panagiotis Karyofillis Anna Kostopoulou +4 位作者 Sofia Thomopoulou Martha Habibi Efthimios Livanis George Karavolias Vassilis Voudris 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2018年第1期105-112,共8页
In the last few years, transcatheter aortic valve implantation (TAVI) has become an alternative procedure in patients with severe aortic stenosis and high risk for surgical aortic replacement. Due to the anatomic co... In the last few years, transcatheter aortic valve implantation (TAVI) has become an alternative procedure in patients with severe aortic stenosis and high risk for surgical aortic replacement. Due to the anatomic correlation between aortic valve structure and conduction system of the heart, one of the most common complications after TAVI is conduction system disturbances which including bundle branch block, complete heart block and need for permanent pacemaker implantation. Although these disturbances are usually not lethal, they may have a great influence on patients' state and long term-survival. Several risk factors for conduction disturbances have been identified which including age, anatomy of the heart, periprocedural factors, type of implanted valve, preexisting abnormalities and comorbidities. As this technique becomes more familiar to physicians, patients should be carefully screened for risk factors for the development of conduction abnormalities after TAVI in order to provide effective prevention and proper treatment. 展开更多
关键词 Atrioventricular block Bundle branch block pacemaker Transcatheter aortic valve implantation
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Feasibility of MRI in Patients with Non-Pacemaker/Defibrillator Metallic Devices and Abandoned Leads
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作者 Prabhakaran P. Gopalakrishnan Loretta Gevenosky Robert W. W. Biederman 《Journal of Biomedical Science and Engineering》 2021年第3期83-93,共11页
<em>Objective</em>: To evaluate feasibility of MRI in patients with non-pacemaker (PM)/Implantable cardioverter defibrillator (ICD) metallic devices and abandoned leads. <em>Background</em>: Re... <em>Objective</em>: To evaluate feasibility of MRI in patients with non-pacemaker (PM)/Implantable cardioverter defibrillator (ICD) metallic devices and abandoned leads. <em>Background</em>: Relative safety of MRI performed using specified protocol has been established in MR non-conditional PM/ICDs. With limited safety data, many non-PM/ICD metallic devices and abandoned leads continue to be a contraindication for MRI. <em>Methods</em>: We retrospectively analyzed consecutive patients with extra-cardiac devices, non-programmable cardiac devices, and abandoned leads, who underwent MRI (GE 1.5 Tesla, WI) at a single tertiary care center over a span of 13 years. Scan protocol was designed to maintain specific absorption rate (SAR) < 4.0 W/kg and scan time < 60 minutes. <em>Results</em>: The cohort comprised 127 MRI exams representing 94 patients, with 13 patients having two or more scans. The devices consisted of: 23 vagal nerve stimulators (VNS), 22 implantable loop recorders, 16 spinal stimulators, 5 peripheral nerve stimulators, 3 bladder stimulators, 2 deep brain stimulators, 1 gastric stimulator, 1 bone stimulator, 1 WATCHMAN device, 22 abandoned PM/lCD leads and 1 VNS lead. There was no immediate (peri-MRI exam) morbidity or mortality. Patients did not report any discomfort, palpitations, heating, or sensation of device migration during the exam. Local follow-up data was available in 65% (100% for thoracic imaging) with a mean of 190 ± 475 days (median 13 days). No device malfunction was reported during follow-up. <em>Conclusions</em>: With appropriate precautions, MRI is feasible in patients with extracardiac devices, nonprogrammable cardiac devices, and abandoned leads. 展开更多
关键词 MRI Safety pacemaker Abandoned Leads implantable Loop Recorder Extra-Cardiac Devices
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心律失常与起搏领域临床研究2023年度进展
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作者 吴寸草 李学斌 《中国介入心脏病学杂志》 CSCD 2024年第1期20-23,共4页
回顾2023年心律失常领域重要临床试验,涉及心房颤动(房颤)、起搏等方面。CIRDADOSE研究及EARLY-AF研究均肯定冷冻球囊消融治疗房颤疗效,减慢房颤进展。MANIFEST-PF研究回顾房颤脉冲场消融的成功率及安全性,在ADVENT研究中再次证实其安... 回顾2023年心律失常领域重要临床试验,涉及心房颤动(房颤)、起搏等方面。CIRDADOSE研究及EARLY-AF研究均肯定冷冻球囊消融治疗房颤疗效,减慢房颤进展。MANIFEST-PF研究回顾房颤脉冲场消融的成功率及安全性,在ADVENT研究中再次证实其安全性和有效性不劣于传统热消融。在左束支区域起搏(LBBAP)研究中,与双心室起搏(BVP)相比,LBBAP降低持续性室性心动过速(VT)/心室颤动(VF)和新发房颤发生率。对于起搏比例高且射血分数降低的起搏器或植入式心律转复除颤器(ICD)患者,BUDAPEST CRT升级研究肯定了其升级到心脏再同步除颤器(CRT-D)的明确获益。DANPACEⅡ研究显示窦房结功能障碍患者的心房起搏最小化并不能降低房颤的发生率。IDE研究显示Aveir DR双腔无导线起搏器术后3个月安全性良好,可提供可靠的心房起搏和房室同步。iSUSI研究是对皮下植入式心律转复除颤器的注册研究,发现心力衰竭和非心力衰竭患者不恰当和恰当电击率相似。 展开更多
关键词 临床试验 心房颤动 冷冻球囊消融 脉冲场消融 左束支区域起搏 CRT升级 无导线起搏器 植入式除颤器
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主动固定电极对心脏起搏器置入术患者心室起搏参数的影响
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作者 刘一鸣 吕静 《中华养生保健》 2024年第5期44-47,共4页
目的探讨与分析主动固定电极对心脏起搏器置入术患者心室起搏参数的影响。方法选择2020年1月—2023年4月新疆生产建设兵团第二师库尔勒医院收治的需安置埋藏式心脏起搏器的85例患者作为研究对象,根据随机掷骰子原则把85例患者分为主动组... 目的探讨与分析主动固定电极对心脏起搏器置入术患者心室起搏参数的影响。方法选择2020年1月—2023年4月新疆生产建设兵团第二师库尔勒医院收治的需安置埋藏式心脏起搏器的85例患者作为研究对象,根据随机掷骰子原则把85例患者分为主动组(43例)与被动组(42例)。主动组采用主动固定电极行右室流出道间隔部、希氏束起搏治疗,被动组采用被动固定电极行右室心尖部起搏治疗,记录与观察两组心室起搏参数变化情况。结果主动组起搏器置入即刻的心室起搏参数起搏阈值、阻抗、P波幅度、电流均明显低于被动组,差异有统计学意义(P<0.05)。主动组电极置入时间、曝光时间均长于被动组,差异有统计学意义(P<0.05)。主动组电极置入后7 d起搏系统感染、下肢深静脉血栓、起搏电极脱位、起搏功能障碍等并发症发生率明显低于被动组,差异有统计学意义(P<0.05)。主动组的下肢制动时间、住院时间、临时心脏起搏电极留置时间均短于被动组,差异有统计学意义(P<0.05)。结论主动固定电极在心脏起搏器置入术患者中的应用能改善其心室起搏参数,增加患者的电极置入时间、曝光时间,减少右心尖起搏带来的心室非同步的电激动,降低患者的并发症发生率,改善患者的总体预后。 展开更多
关键词 主动固定电极 心脏起搏器置入术 心室起搏参数 右室心尖部 被动固定电极
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瓣环与左室流出道椭圆率比值及瓣环离心指数对TAVR患者远期预后的预测价值
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作者 吴国良 朱嘉俊 +4 位作者 赵龙 于子翔 陈清杰 李晓梅 杨毅宁 《中国循证心血管医学杂志》 2024年第4期484-489,共6页
目的分析探讨主动脉根部因素瓣环与左室流出道(LVOT)椭圆率比值、瓣环离心指数对经导管主动脉瓣置换术(TAVR)患者远期预后的预测价值。方法回顾性分析2016年1月至2022年5月于新疆医科大学第一附属医院心脏中心行TAVR治疗的主动脉瓣狭窄(... 目的分析探讨主动脉根部因素瓣环与左室流出道(LVOT)椭圆率比值、瓣环离心指数对经导管主动脉瓣置换术(TAVR)患者远期预后的预测价值。方法回顾性分析2016年1月至2022年5月于新疆医科大学第一附属医院心脏中心行TAVR治疗的主动脉瓣狭窄(AVS)患者86例,根据患者瓣环离心指数与瓣环形态的关系,分为离心指数<0.1组(n=62)及离心指数≥0.1组(n=24),同时根据患者瓣环与LVOT形态相似程度优劣将患者分为椭圆率比值>1组(n=23)及椭圆率比值≤1组(n=63)。分别比较瓣环离心指数、瓣环与LVOT椭圆率比值对患者远期预后的影响,并用Cox回归分析影响TAVR患者预后的预测因素。使用ROC曲线、校准曲线、DCA曲线分析预测能力的效能、精准度、临床效用。结果多因素Cox回归结果:瓣环离心指数<0.1(HR:0.13,95%CI:0.02~0.86,P=0.034)、瓣环与LVOT椭圆率比值>1(HR:7.98,95%CI:1.85~34.39,P=0.005)、无冠状窦下瓣膜植入深度>5 mm(HR:5.29,95%CI:1.51~18.55,P=0.009)是TAVR术后远期(1年)永久起搏器植入(PPI)的独立预测因素。ROC曲线、校准曲线、DCA曲线分析结果分别提示:瓣环与LVOT椭圆率比值、瓣环离心指数联合瓣膜植入深度预测远期PPI的效能较好(AUC:0.919,95%CI:0.822~1.000,P<0.001),精准度较高(C指数为0.894,95%CI:0.809~0.979,P<0.001),且具有一定临床效用。结论作为AVS患者主动脉根部差异的评估方式,瓣环与LVOT椭圆率比值、瓣环离心指数对TAVR患者远期预后具有一定预测价值,且联合已知预测因素瓣膜植入深度预测远期PPI的效能较好、精准度较高,具有一定临床效用。 展开更多
关键词 经导管主动脉瓣置换术 起搏器植入 椭圆率比值 离心指数
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