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病例报告展示了单心室心脏中无导线起搏器植入的新方法。

Case report demonstrating novel approaches for leadless pacemaker implantation in the single ventricle heart.

作者信息

Hayle Patrick, Altayeb Fatima, Hale Angela, Rao Archana, Ashrafi Reza

机构信息

Department of Cardiology, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK.

出版信息

Eur Heart J Case Rep. 2025 Mar 28;9(4):ytaf146. doi: 10.1093/ehjcr/ytaf146. eCollection 2025 Apr.

DOI:10.1093/ehjcr/ytaf146
PMID:40302980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12038896/
Abstract

BACKGROUND

The congenital heart disease population can provide a unique set of challenges during pacemaker implant, including the necessity of transvenous leads in a young group of patients. In this case report we demonstrate how leadless pacemakers may be used as an option in patients with Fontan circulation.

CASE SUMMARY

We present two cases of novel use of the Abbott AVEIR™ leadless pacemaker, including the first reported in person trans-baffle delivery of this device and implantation into a single ventricle heart. Our cases are a 30-year-old male with single ventricle physiology and Fontan circulation, found incidentally to have complete heart block (CHB) and a 48-year-old female with a Fontan circulation who had CHB and a history of syncope. These cases demonstrate a variety of venous access routes and add to the existing data of leadless pacemaker implantation in single ventricle physiology. The very long battery life of these devices make them ideal for patients with difficult venous access with bradycardia pacing requirement with low pacing burden.

DISCUSSION

Leadless pacemakers offer a valuable alternative to transvenous pacing leads for providing bradycardia pacing support in this patient population.

摘要

背景

先天性心脏病患者在植入起搏器时会面临一系列独特的挑战，包括在年轻患者群体中使用经静脉导线的必要性。在本病例报告中，我们展示了无导线起搏器如何可作为Fontan循环患者的一种选择。

病例总结

我们介绍了两例新型使用雅培AVEIR™无导线起搏器的病例，包括首次报告的该设备经挡板直接递送并植入单心室心脏的情况。我们的病例包括一名30岁男性，具有单心室生理特征和Fontan循环，偶然发现患有完全性心脏传导阻滞（CHB）；以及一名48岁女性，具有Fontan循环，患有CHB且有晕厥病史。这些病例展示了多种静脉通路途径，并补充了单心室生理状态下无导线起搏器植入的现有数据。这些设备非常长的电池寿命使其成为静脉通路困难、有心动过缓起搏需求且起搏负担低的患者的理想选择。

讨论

无导线起搏器为该患者群体提供心动过缓起搏支持时，是经静脉起搏导线的一种有价值的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/10e656fa2408/ytaf146f7.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/b741689eca6e/ytaf146f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/bd8b444768b7/ytaf146f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/65740a8b6701/ytaf146f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/30d839fadc42/ytaf146f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/10e656fa2408/ytaf146f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/c718aea842b0/ytaf146il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/d2421ccc0319/ytaf146f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/f6d5f34607d9/ytaf146f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/b741689eca6e/ytaf146f3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/65740a8b6701/ytaf146f5.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806e/12038896/10e656fa2408/ytaf146f7.jpg

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Bioact Mater. 2023 Jun 25;28:467-479. doi: 10.1016/j.bioactmat.2023.06.014. eCollection 2023 Oct.
3
Implant efficiency and clinical performance of Aveir™ VR and Micra™ VR leadless pacemaker: A multicenter comparative analysis of 67 patients.
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Pacing Clin Electrophysiol. 2023 Aug;46(8):827-832. doi: 10.1111/pace.14766. Epub 2023 Jun 29.
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A Dual-Chamber Leadless Pacemaker.双腔无导线起搏器。
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