Yashiro Bun, Shoda Morio, Tomizawa Yasuko, Manaka Tetsuyuki, Hagiwara Nobuhisa
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
J Artif Organs. 2012 Sep;15(3):244-9. doi: 10.1007/s10047-012-0634-8. Epub 2012 Feb 25.
The use of an expanded polytetrafluoroethylene (ePTFE) sheet wrapping device for patients with pacemaker contact dermatitis is still controversial. This study aimed to retrospectively investigate the occurrence rate of allergies and other complications after implantation of a cardiovascular implantable electronic device (CIED) wrapped with an ePTFE sheet. A total of 4,497 procedures of CIED implantation were performed at our institution between January 1993 and April 2010. Among 19 patients who underwent implantation of an electronic cardiac device wrapped with an ePTFE sheet, device implantation was performed in 11 patients for secondary prevention of device contact sensitivity, in 7 patients for primary prevention of device contact sensitivity, and in 1 patient for avoiding over-sensing of myopotentials. During follow-up periods (mean 46 ± 34 months), there were no allergic or inflammatory reactions to components of the device or ePTFE itself. Among 11 patients with a device wrapped with an ePTFE sheet for secondary prevention, 5 patients completed device replacement due to battery depletion and 3 patients had infections from the device. Wrapping implantable devices with an ePTFE sheet is an effective way of preventing device sensitivity in patients who require CIED therapy. However, the risk of infection from the device should be taken into consideration.
对于起搏器接触性皮炎患者使用膨体聚四氟乙烯(ePTFE)片包裹装置仍存在争议。本研究旨在回顾性调查使用ePTFE片包裹的心血管植入式电子装置(CIED)植入后过敏及其他并发症的发生率。1993年1月至2010年4月期间,我院共进行了4497例CIED植入手术。在19例接受ePTFE片包裹的电子心脏装置植入患者中,11例患者进行装置植入是为了二级预防装置接触敏感性,7例患者是为了一级预防装置接触敏感性,1例患者是为了避免肌电位过度感知。在随访期间(平均46±34个月),未出现对装置组件或ePTFE本身的过敏或炎症反应。在11例因二级预防使用ePTFE片包裹装置的患者中,5例因电池耗尽完成了装置更换,3例发生了装置感染。用ePTFE片包裹植入式装置是预防需要CIED治疗的患者装置敏感性的有效方法。然而,应考虑装置感染的风险。