Medizinische Klinik II, Klinikum Kassel, Kassel, Germany.
Clin Res Cardiol. 2012 Apr;101(4):239-45. doi: 10.1007/s00392-011-0407-z. Epub 2012 Jan 10.
The preferred use of dual-coil implantable defibrillator lead systems in current implantable defibrillator therapy is likely based on data showing statistically lower defibrillation thresholds with dual-coil defibrillator lead systems. The following review will summarize the clinical data for dual- versus single-coil defibrillator leads in the left and right pectoral implant locations, and will then discuss the clinical implications of single- versus dual-coil usage for atrial defibrillation, venous complications, and the risks associated with lead extraction. It will be noted that there are no comparative clinical studies on the use and outcomes of single- versus dual-coil lead systems in implantable defibrillator therapy over a long-term follow-up. The limited long-term reliability of defibrillator leads is a major concern in implantable defibrillator and cardiac resynchronization therapy. A simpler single-coil defibrillator lead system may improve the long-term performance of implanted leads. Furthermore, the superior vena cava coil is suspected to increase interventional risk in transvenous lead extraction. Therefore, the need for objective data on extractions and complications will be emphasized.
在当前的植入式除颤器治疗中，双线圈植入式除颤器导联系统的首选使用可能基于数据显示双线圈除颤器导联系统具有统计学上更低的除颤阈值。以下综述将总结左、右胸肌植入部位双线圈与单线圈除颤器导联的临床数据，然后讨论单线圈与双线圈在心房除颤、静脉并发症以及与导联提取相关的风险方面的临床意义。需要注意的是，在植入式除颤器治疗中，尚无关于单线圈与双线圈导联系统在长期随访中的使用和结果的比较性临床研究。除颤器导联的有限长期可靠性是植入式除颤器和心脏再同步治疗中的一个主要关注点。更简单的单线圈除颤器导联系统可能会提高植入导联的长期性能。此外，上腔静脉线圈被怀疑会增加经静脉导联提取的介入风险。因此，需要强调有关提取和并发症的客观数据。
