Semmler Georg, Barbieri Fabian, Thudt Karin, Vock Paul, Mörtl Deddo, Mayr Harald, Wollmann Christian Georg, Adukauskaite Agne, Pfeifer Bernhard, Senoner Thomas, Dichtl Wolfgang
Department of Internal Medicine III, University Clinic St. Pölten & Karl Landsteiner Private University, 3100 St. Pölten, Austria.
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, 1090 Vienna, Austria.
J Clin Med. 2021 Feb 8;10(4):639. doi: 10.3390/jcm10040639.
Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature.
All patients undergoing implantation of the Osypka QT-5 ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed ( = 211). Clinical data including pacemaker follow-up examinations and the need for lead revisions were assessed. Kaplan-Meier analysis to estimate the rate of lead dysfunction during long-term follow-up was conducted.
Patients were followed for a median of 5.2 years (interquartile range (IQR) 2.0-8.7). R-wave sensing properties at implantation, compared to last follow-up, remained basically unchanged: 9.9 mV (IQR 6.8-13.4) and 9.6 mV (IQR 5.6-12.0), respectively). Ventricular pacing threshold significantly increased between implantation (0.5 V at 0.4 ms; IQR 0.5-0.8) and the first follow-up visit (1.0 V at 0.4 ms; IQR 0.8-1.3; < 0.001) and this increase persisted throughout to the last check-up (0.9 V at 0.4 ms; IQR 0.8-1.2). Impedance significantly declined from 1142 Ω (IQR 955-1285) at implantation to 814 Ω (IQR 701-949; < 0.001) at the first check-up, followed by a further decrease to 450 Ω (IQR 289-652; < 0.001) at the last check-up. Overall, the Osypka QT-5 ventricular lead was replaced in 36 patients (17.1%).
This report shows an unexpected high rate of technical issues of the Osypka QT-5 ventricular lead during long-term follow-up.
心脏植入式电子设备患者中与铅相关的并发症和技术问题很常见，但在文献中报道不足。
对2006年1月1日至2012年12月31日期间在圣珀尔滕大学诊所接受奥西普卡QT-5心室导线植入的所有患者（n = 211）进行回顾性分析。评估包括起搏器随访检查和导线修订需求在内的临床数据。进行Kaplan-Meier分析以估计长期随访期间导线功能障碍的发生率。
患者的中位随访时间为5.2年（四分位间距[IQR] 2.0 - 8.7）。与最后一次随访相比，植入时的R波感知特性基本保持不变：分别为9.9 mV（IQR 6.8 - 13.4）和9.6 mV（IQR 5.6 - 12.0）。心室起搏阈值在植入时（0.4 ms时为0.5 V；IQR 0.5 - 0.8）和首次随访时（0.4 ms时为1.0 V；IQR 0.8 - 1.3；P < 0.001）之间显著增加，并且这种增加一直持续到最后一次检查（0.4 ms时为0.9 V；IQR 0.8 - 1.2）。阻抗从植入时的1142 Ω（IQR 955 - 1285）显著下降到首次检查时的814 Ω（IQR 701 - 949；P < 0.001），随后在最后一次检查时进一步下降到450 Ω（IQR 289 - 652；P < 0.001）。总体而言，36例患者（17.1%）更换了奥西普卡QT-5心室导线。
本报告显示在长期随访期间奥西普卡QT-5心室导线出现技术问题的发生率意外地高。
