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两种无导线起搏器在临床实践中的比较研究。

A comparative study of the two leadless pacemakers in clinical practice.

作者信息

Shantha Ghanshyam, Brock Jonathan, Singleton Matthew J, Schmitt Alexander Joseph, Kozak Patrick, Bodziock George, Bradford Natalie, Whalen Patrick, Bhave Prashant

机构信息

Cardiac Electrophysiology, Wake Forest University, Winston-Salem, North Carolina, USA.

Wellspan Hospital, York, Pennsylvania, USA.

出版信息

J Cardiovasc Electrophysiol. 2023 Sep;34(9):1896-1903. doi: 10.1111/jce.16019. Epub 2023 Jul 31.

Abstract

INTRODUCTION

AVEIR-VR leadless pacemaker (LP) was recently approved for clinical use. Although trial data were promising, post-approval real world data with regard to its effectiveness and safety is lacking. To report our early experience with AVEIR-VR LP with regard to its effectiveness and safety and compare it with MICRA-VR.

METHODS

The first 25 patients to undergo AVEIR-VR implant at our institution between June and November 2022, were compared to 25 age- and sex-matched patients who received MICRA-VR implants.

RESULTS

In both groups, mean age was 73 years and 48% were women. LP implant was successful in 100% of patients in both groups. Single attempt deployment was achieved in 80% of AVEIR-VR and 60% of MICRA-VR recipients (p = 0.07). Fluoroscopy, implant, and procedure times were numerically longer in the AVEIR-VR group compared to MICRA-VR group (p > 0.05). No significant periprocedural complications were noted in both groups. Incidence of ventricular arrhythmias were higher in the AVEIR-VR group (20%) compared to the MICRA-VR group (0%) (p = 0.043). At 2 and 8 weeks follow-up, device parameters remained stable in both groups with no device dislodgements. The estimated battery life at 8 weeks was significantly longer in the AVEIR-VR group (15 years) compared to the MICRA-VR group (8 years) (p = 0.047). With 3-4 AVEIR-VR implants, the learning curve for successful implantation reached a steady state.

CONCLUSION

Our initial experience with AVEIR-VR show that it has comparable effectiveness and safety to MICRA-VR. Larger sample studies are needed to confirm our findings.

摘要

引言

AVEIR-VR无导线起搏器(LP)最近被批准用于临床。尽管试验数据很有前景,但关于其有效性和安全性的批准后真实世界数据尚缺。报告我们在AVEIR-VR LP有效性和安全性方面的早期经验,并将其与MICRA-VR进行比较。

方法

将2022年6月至11月在我们机构接受AVEIR-VR植入的前25例患者与25例年龄和性别匹配的接受MICRA-VR植入的患者进行比较。

结果

两组的平均年龄均为73岁,48%为女性。两组100%的患者LP植入成功。80%的AVEIR-VR接受者和60%的MICRA-VR接受者实现了单次尝试植入(p = 0.07)。与MICRA-VR组相比,AVEIR-VR组的透视、植入和手术时间在数值上更长(p > 0.05)。两组均未发现明显的围手术期并发症。AVEIR-VR组的室性心律失常发生率(20%)高于MICRA-VR组(0%)(p = 0.043)。在2周和8周随访时,两组的设备参数均保持稳定,无设备移位。与MICRA-VR组(8年)相比,AVEIR-VR组在8周时的估计电池寿命明显更长(15年)(p = 0.047)。植入3-4个AVEIR-VR后,成功植入的学习曲线达到稳定状态。

结论

我们在AVEIR-VR方面的初步经验表明,它在有效性和安全性方面与MICRA-VR相当。需要更大规模的样本研究来证实我们的发现。

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