Martí V, Gurgui M, Padró J M, Oter R, Rodríguez O
Department de Cardiologia, Hospital de la Santa Creu i Sant Pau, Barcelona.
Rev Esp Cardiol. 1994 Feb;47(2):81-5.
The aim of the present study was to evaluate the complications in patients with functionless pacing leads retained in the cardiovascular system.
We retrospectively studied 39 patients: 31 underwent surgery for electrical or mechanical failure (group I) and eight for cutaneous pocket infection (group II). The follow-up was 45 +/- 34 months.
Only one patient (3%) from group I presented infectious complications probably related to the retained pacing lead. Seven patients (87%) in group II presented recurrence of the infection with persistent fever and/or septicemia due to skin erosion and unnoticed pacing lead infection (p < 0.0005). Removal of the infected generator was performed in 8/39 (21%) of the patients. Thoracotomy to explant the infected retained leads was required in five of them (62%). No patient presented lead migration or venous thrombosis during the follow-up.
Retained pacing leads in the cardiovascular system are well tolerated. However, in spite of adequate antibiotic treatment, patients with local and pacemaker system infection may present recurrence of the infection with persistent fever and/or septicemia. Early surgical pacemaker system removal is recommended in these patients due to the high morbidity.
本研究旨在评估心血管系统中保留无功能起搏导线患者的并发症情况。
我们对39例患者进行了回顾性研究：31例因电气或机械故障接受手术（I组），8例因皮肤囊袋感染接受手术（II组）。随访时间为45±34个月。
I组仅1例患者（3%）出现可能与保留的起搏导线相关的感染并发症。II组7例患者（87%）因皮肤糜烂和未被注意到的起搏导线感染出现感染复发，伴有持续发热和/或败血症（p<0.0005）。39例患者中有8例（21%）进行了感染发生器的移除。其中5例（62%）需要开胸取出感染的保留导线。随访期间无患者出现导线移位或静脉血栓形成。
心血管系统中保留的起搏导线耐受性良好。然而，尽管进行了充分的抗生素治疗，局部和起搏器系统感染的患者仍可能出现感染复发，伴有持续发热和/或败血症。鉴于高发病率，建议对这些患者尽早进行手术移除起搏器系统。
