Shoda Morio, Kusano Kengo, Goya Masahiko, Nishii Nobuhiro, Imai Katsuhiko, Okamoto Yoji, Takegami Misa, Nakao Yoko M, Miyamoto Yoshihiro, Nogami Akihiko, Shimizu Wataru
Clinical Research Division of Heart Rhythm Management, Department of Cardiology Tokyo Women's Medical University Tokyo Japan.
Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
J Arrhythm. 2022 Feb 4;38(2):187-191. doi: 10.1002/joa3.12678. eCollection 2022 Apr.
Along with the incremental cases of cardiac implantable electronic devices implantation or upgrade, the lead-related complications are also in rise year after year. The most common and serious lead-related complication is infection that needs a transvenous lead extraction (TLE) as the first-line therapy. TLE is also performed for abandoned leads in case of lead failure or device upgrade, and for lead-related trouble such as pain, vessel stenosis or occlusion, too many leads, tricuspid valve regurgitation, and difficulty of radiation therapy. This registration has been performed by the Japanese Heart Rhythm Society and started in July 2018. The first reported data of the Japanese Lead Extraction (J-LEX) from July 2018 to December 2019 were underestimated since the number of patients and hospitals increased gradually because of the approval process of each hospital's IRB. The TLE procedure was attempted to 1253 leads among 661 patients. Complete removal was achieved in 96.7% of the target leads and the clinical success was obtained in 98.9% of the patients. Perioperative complications were observed in 4.1% of the patients. The annual J-LEX report reflects a real-world TLE medicine in Japan and demonstrates that the clinical outcome is similar to former reports from high-volume centers in North America and European countries.
随着心脏植入式电子设备植入或升级病例的不断增加,与导线相关的并发症也逐年上升。最常见且严重的与导线相关的并发症是感染,对此需要进行经静脉导线拔除术(TLE)作为一线治疗方法。在导线故障或设备升级时,以及出现与导线相关的问题,如疼痛、血管狭窄或闭塞、导线过多、三尖瓣反流和放射治疗困难等情况时,也会进行TLE以拔除废弃导线。这项登记工作由日本心律学会开展,于2018年7月启动。由于各医院伦理审查委员会的审批流程,患者和医院数量逐渐增加,2018年7月至2019年12月期间首次报告的日本导线拔除(J-LEX)数据被低估。对661例患者的1253根导线尝试进行了TLE手术。96.7%的目标导线实现了完全拔除,98.9%的患者获得了临床成功。4.1%的患者出现了围手术期并发症。年度J-LEX报告反映了日本TLE医学的实际情况,并表明临床结果与北美和欧洲国家大容量中心以前的报告相似。