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病例报告:无导线起搏器和左束支区域起搏器,互补优势需要个性化方法。

Case Report: Leadless and left bundle branch area pacemakers, complementary advantages require a personalized approach.

作者信息

Yousuf Omair, Lee Jae Jeff, Atwater Brett D

机构信息

Carient Heart & Vascular, Vienna, VA, United States.

University of Virginia Health, Manassas, VA, United States.

出版信息

Front Cardiovasc Med. 2024 Jul 30;11:1373884. doi: 10.3389/fcvm.2024.1373884. eCollection 2024.

Abstract

Traditional transvenous pacemakers consist of a pacemaker generator usually positioned surgically in the upper left chest on the pectoral muscle fascia and one or more leads positioned through the veins to the right atrium and across the tricuspid valve to the right ventricular apex. While these devices reduce symptoms and improve survival among patients with symptomatic bradycardia, they are associated with an increased risk of infection, venous occlusion, heart failure, and tricuspid valve regurgitation. Although new pacemaker designs minimize these risks, none of the current-generation pacemaker designs effectively eliminate all of them. A personalized approach to selecting the appropriate pacemaker for each patient is needed to optimize outcomes.

摘要

传统的经静脉起搏器由一个通常通过手术放置在左胸上部胸肌筋膜上的起搏器发生器,以及一根或多根经静脉放置到右心房并穿过三尖瓣到达右心室尖部的导线组成。虽然这些装置可减轻有症状心动过缓患者的症状并提高生存率,但它们与感染、静脉闭塞、心力衰竭和三尖瓣反流风险增加有关。尽管新的起搏器设计将这些风险降至最低,但目前一代的起搏器设计都无法有效消除所有风险。需要采用个性化方法为每位患者选择合适的起搏器,以优化治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f05/11320998/d0f9cfeb0499/fcvm-11-1373884-g001.jpg

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