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孤立性永存左上腔静脉患者无导线起搏器植入的技术要点及疗效

Technical Tips and Efficacy of Leadless Pacemaker Implantation in a Patient With Isolated Persistent Left Superior Vena Cava.

作者信息

Tokonami Yuki, Sano Makoto, Narumi Taro, Naruse Yoshihisa, Maekawa Yuichiro

机构信息

Division of Cardiology, Internal Medicine III Hamamatsu University School of Medicine Hamamatsu Japan.

出版信息

J Arrhythm. 2025 Jul 18;41(4):e70149. doi: 10.1002/joa3.70149. eCollection 2025 Aug.

DOI:10.1002/joa3.70149
PMID:40687633
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12274290/
Abstract

Isolated persistent left superior vena cava (PLSVC) provides limited access during transvenous pacemaker implantation. We present a case of implantation of a leadless pacemaker for atrioventricular block with isolated PLSVC. A leadless pacemaker is an alternative strategy to a transvenous pacemaker; however, some technical tips are required: (1) the prevention of the mis-insertion in the dilated coronary sinus and (2) the pre-assessment of the anatomy of the right atrium and ventricle.

摘要

孤立性永存左上腔静脉（PLSVC）在经静脉起搏器植入过程中提供的通路有限。我们报告一例因孤立性PLSVC伴房室传导阻滞植入无导线起搏器的病例。无导线起搏器是经静脉起搏器的一种替代策略；然而，需要一些技术要点：（1）防止误插入扩张的冠状静脉窦，以及（2）对右心房和右心室的解剖结构进行术前评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fed/12274290/aec020ae350b/JOA3-41-e70149-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fed/12274290/1917f5f3dfcf/JOA3-41-e70149-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fed/12274290/aec020ae350b/JOA3-41-e70149-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fed/12274290/1917f5f3dfcf/JOA3-41-e70149-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fed/12274290/aec020ae350b/JOA3-41-e70149-g001.jpg

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本文引用的文献

1
Jugular Approach for the Transcatheter Pacemaker Implant　- Better Access for Smaller Hearts?颈静脉入路在经导管心脏起搏器植入术中的应用 - 更小的心脏是否有更好的入路？
Circ J. 2024 Jun 25;88(7):1127-1134. doi: 10.1253/circj.CJ-24-0083. Epub 2024 Apr 24.
2
Imaging assessment of the right atrium: anatomy and function.右心房的影像学评估：解剖与功能。
Eur Heart J Cardiovasc Imaging. 2022 Jun 21;23(7):867-884. doi: 10.1093/ehjci/jeac011.
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Optimal technique for right ventricular lead implantation in isolated persistent left superior vena cava.
孤立性永存左上腔静脉患者右心室导线植入的最佳技术
Europace. 2022 Jan 4;24(1):11. doi: 10.1093/europace/euab111.
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Atrioventricular Synchronous Pacing Using a Leadless Ventricular Pacemaker: Results From the MARVEL 2 Study.使用无导线心室起搏器实现房室同步起搏：MARVEL 2 研究结果。
JACC Clin Electrophysiol. 2020 Jan;6(1):94-106. doi: 10.1016/j.jacep.2019.10.017. Epub 2019 Nov 11.
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Absent right superior vena cava in visceroatrial situs solitus.内脏心房位置正常时右头臂静脉缺如。
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