Cardiology Department, Na Homolce Hospital, Prague, Czech Republic.
Cardiology Department, Na Homolce Hospital, Prague, Czech Republic.
JACC Clin Electrophysiol. 2020 Dec;6(14):1744-1751. doi: 10.1016/j.jacep.2020.06.010. Epub 2020 Aug 26.
The authors report their single-center experience with the retrieval and replacement of long-term implanted leadless cardiac pacemakers (LPs) and the factors contributing to success.
LPs are a clinically effective and safe alternative to standard transvenous pacemakers for single-chamber ventricular pacing. However, the feasibility of retrieving and replacing long-term implanted LPs is not well known.
A total of 34 patients with implanted Nanostim LPs (mean implantation duration 1,570 ± 479 days) subsequently underwent retrieval. On the basis of fluoroscopic imaging, the cohort was divided into 2 groups: those with remarkable swinging movement (SM) of the LP docking button (n = 25) and those without SM (n = 9).
The overall LP retrieval success rate was 85% (n = 29). New leadless devices were implanted in 27 patients immediately after LP retrieval. No procedure-related adverse events occurred. The rate of successful LP retrieval was significantly higher in the SM group (25 of 25 [100%]) than in the no-SM group (4 of 9 [44%]) (p < 0.001), and fluoroscopy time during the retrieval procedure was shorter in the SM group (12.7 ± 8.6 min) than in the no-SM group (45.6 ± 19 min) (p < 0.001).
This study demonstrated the feasibility and safety of retrieval of long-term implanted LPs after a mean duration of 4 years. Retrieval was most successful in patients whose docking buttons exhibited significant SM.
作者报告了他们在单个中心的经验，即检索和更换长期植入的无导线心脏起搏器（LPs），并探讨了成功的因素。
LPs 是一种替代标准经静脉起搏器的有效且安全的方法，用于单腔心室起搏。然而，长期植入 LPs 的可检索性和可替换性尚不清楚。
共有 34 名植入 Nanostim LPs 的患者（植入时间中位数为 1570±479 天）随后接受了检索。根据荧光透视成像，将该队列分为 2 组：LP 对接按钮有明显摆动运动（SM）的组（n=25）和没有 SM 的组（n=9）。
总体 LP 检索成功率为 85%（n=29）。27 名患者在 LP 检索后立即植入了新的无导线装置。没有发生与程序相关的不良事件。SM 组的 LP 检索成功率明显高于无 SM 组（25/25 [100%] vs. 4/9 [44%]）（p<0.001），并且 SM 组的荧光透视时间较短（12.7±8.6 分钟）比无 SM 组（45.6±19 分钟）（p<0.001）。
本研究表明，在平均 4 年的时间后，检索长期植入的 LPs 是可行且安全的。在对接按钮显示明显 SM 的患者中，检索成功率最高。
